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Little Horn is a passive item added in Afterbirth †.
Effects
- Running into enemies deals 3.5 damage to them.
- Adds a chance to fire piercing tears which will instantly kill any non-boss enemy.
Notes
- The special tears will kill some normally invulnerable monsters, such as Death's Heads, Stoneys, and Peep's floating eyeballs.
- The special tears can also destroy Blue Fireplaces and Purple Fireplaces.
- The special tears can destroy the various spiked blocks (Wall Hugger, Slide, and Poky) as well as the variants of Stone Grimace. All of these won't respawn if Isaac leaves and re-enters the room.
- The contact damage effect overrides the superior contact damage from
Aries, The Gamekid, My Little Unicorn / Error: The given collectible ("VII - The Chariot") does not exist. and The Nail. Only Midas' Touch still works and deals an additional 3.5 damage.
Synergies
- 20/20/Cursed Eye/The Inner Eye/Mutant Spider: Little Horn tears are more likely to be fired.
- Angelic Prism: Little Horn tears can be split by the prism and will be quadrupled when they pass through it.
- Compound Fracture/Cricket's Body/The Parasite: Little Horn tears will split into smaller tears with effect.
- Evil Eye: Eyes can fire Little Horn tears. Little Horn tears won't destroy other eyes.
- Homing Tears: Little Horn tears will home in on enemies.
- Ipecac: Projectiles gain the effect, piercing through and instantly killing most enemies, and then exploding upon landing.
- Kidney Stone: The stone can have the Little Horn effect.
- Lachryphagy: Occasionally, tears with Little Horn effect are fired. If Little Horn tears are fed, they will burst into split tears with the same effect. If Little Horn tears feed normal tears, the Little Horn effect is not applied to them.
- Lead Pencil/Monstro's Lung: Little Horn tears are more likely to be fired.
- Soy Milk: Due to the higher tear rate, the special tears will be fired much more frequently.
- The Virus/Serpent's Kiss: Allows harvesting black hearts from Stone Grimaces as they can be (invisibly) poisoned by touching them, then destroyed with Little Horn.
Interactions
- Brimstone: Overrides Little Horn.
- Dr. Fetus: Occasionally, some bombs are black. Purely cosmetic effect.
- Epic Fetus: Occasionally, the missile clouds are black. Purely cosmetic effect.
- Haemolacria: Occasionally, tears are fired with Little Horn that split into burst tears with same effect.
- The Ludovico Technique: Tear occasionally changes color and can kill enemies instantly.
- Mom's Knife: Overrides Little Horn.
- Technology: Overrides Little Horn.
- Tech X: Overrides Little Horn.
- Technology Zero: Electricity connected to Little Horn tears will not instantly kill enemies.
- Trisagion: Occasionally, some beams are black. Purely cosmetic effect.
Trivia
- This item might be a reference to Cutaneous horns, unusual keratinous skin tumors with the appearance of horns.
In-game Footage
 The Binding of Isaac: Rebirth
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