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Font TeamMeat L.pngFont TeamMeat e.pngFont TeamMeat e.pngFont TeamMeat c.pngFont TeamMeat h.png
Item icon
Item altar
Table dividing line 1.png
Table dividing line 2.png
Treasure Room Treasure Room
Greed mode only Devil Room Devil Room
Table dividing line 3.png
Added in Afterbirth(page 3, column 5, row 2)
Removed in Afterbirth(page 3, column 5, row 7)
Disambig.png This article is about the item. For the monster, see Leech (Enemy).

Leech is a passive item.

Effects[edit | edit source]

  • Upon pickup, spawns a crawling Leech that follows Isaac. If an enemy comes near, the Leech will attack and chase it, dealing 1.5 damage per tick or about 3.2 damage per second. If an enemy is killed by the Leech, Isaac will be healed by half a heart.

Notes[edit | edit source]

  • The Leech's healing effect does not affect characters that do not have red heart containers.
    • Added in Afterbirth Keeper will be healed by The Leech.
  • Enemies that turn into flesh piles and regenerate when killed such as Globins and some dark red champions regenerate quicker than the Leech can kill them. Isaac will gain half a heart each time the enemies collapse, granting an easy way to regenerate all red hearts. This can also open up many powerful synergies with any item that provides a benefit or resource when Isaac takes damage.

Synergies[edit | edit source]

  • Arcade Rooms: The player can let the Leech eat flies from the shell game and use the resulting health to gamble on the Blood Bank.
  • BFFS! BFFS!Collectible BFFS! icon.pngIncreases the size and damage of familiars.: Leech grows bigger and does double damage. Still only heals for a half heart.
  • E Coli E ColiCollectible E Coli icon.pngGives "Turdy Touch" Effect. Enemies that touch Isaac are changed into poop.: Enemies can be turned into poop at the cost of half a heart, then consumed by the leech to regain health. Utilization of temporary immunity when hit can allow multiple enemies to be turned into poop, resulting in a net gain of health.
  • Flush! Flush!Collectible Flush! icon.png6 roomsChanges all enemies in the room into poop. Does not work on all enemies (Knights and bosses are immune). Instantly kills Dingle, Dangle, and Brownie.: The leech still is able to attack the enemies turned into poop and gain health.
  • Gnawed Leaf Gnawed LeafCollectible Gnawed Leaf icon.pngAfter standing still and not shooting for a short time, Isaac turns invincible until he moves or shoots.: The player can stand still and allow the Leech to clear a room, granting simple clears and easy health.

Interactions[edit | edit source]

  • Maggy's Bow Maggy's BowCollectible Maggy's Bow icon.pngGives one heart container and doubles the healing provided by red hearts.: No effect on healing.

In-game Footage[edit | edit source]

Bugs[edit | edit source]

Bug Bug! Tends to get confused when attacking Maggot like enemies and just moves around in the attacking animation without attacking anything until the Maggot is killed by The Player.
Bug Bug! The Leech will continuously heal player while it's attacking Mama Gurdy.
Bug Bug! With Leech and Extension Cord, when electricity occasionally connects Isaac and the Leech, it will not always fully connect.

Seeds[edit | edit source]

 PC  M4X7 V0TK (Treasure room adjacent to spawn) (both modes)

 PC  3SWF QKD4 (treasure room to the right of spawn) (normal mode only)

 PS4  G4YR 243A (Treasure room adjacent to spawn)

 Vita  L1Y9 Y1KN (Treasure room adjacent to spawn)

 Vita  2KAD 2W2B (Treasure room adjacent to spawn)

 3DS  YG41 04ZN (Treasure room adjacent to spawn)

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