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Sack Head is a passive item added in the Binding of Isaac: Afterbirth expansion.
- All bomb, coin, key, card, rune, pill, and battery pickups have a 33% chance to be replaced with sacks.
- This includes pickups spawned by anything: chests, slot machines, special shopkeepers, etc.
- Spawns a sack upon pickup.
- Shopkeepers have a chance to drop this item when destroyed.
- Troll Bombs can also be replaced with sacks.
- Contract From BelowDoubles the number of pickups and chests spawned after clearing a room or performing some other triggering action (such as using a blood donation machine), but reduces the chance for any pickups to spawn at all.: Doubles the sacks received after clearing a room.
- D20Rerolls all pickups in the current room.: Sacks often contain batteries. The D20 rerolls opened sack items into batteries and more sacks. Rinse and repeat.
- Equality!Turns pickups into their doubled versions while Isaac's numbers of coins, bombs, and keys are equal.: Sacks may drop new sacks while Equality! is active, potentially resulting in massive amounts of resources from a single sack.
- Flat PennyGives a 50% chance of spawning a key upon collecting a penny.: When picking up a penny, a sack might drop instead of a key. The sack might contain more pennies which leads to more sacks.
- Head of the KeeperIsaac's tears become coins and now have a chance to drop pennies on the floor upon successfully hitting an enemy.: Enemies hit by Isaac's tears have a chance of dropping sacks instead of coins.
- Lucky RockEach obstacle destroyed drops one coin.: Blown up rocks have a high chance of dropping sacks instead of pennies.
- Petrified PoopGreatly increases the chances of a pickup dropping when destroying poop.: Has a high chance to drop sacks by destroying poop.
- Safety ScissorsTroll bombs turn into Bomb pickups before they explode. Mega troll bombs turn into 1+1 free bombs before they explode. + Curse of the TowerCauses Isaac to spawn 6 troll bombs on the floor every time he gets hit, similar to the Anarchist Cookbook mechanic.: Each defused bomb has a chance to be replaced with a sack, so up to six sacks can spawn from taking damage.
- Safety ScissorsTroll bombs turn into Bomb pickups before they explode. Mega troll bombs turn into 1+1 free bombs before they explode. + Anarchist CookbookSpawns six troll bombs around the room.: Each defused bomb has a chance to be replaced with a sack, so up to six sacks can spawn on use. In addition, sacks can spawn batteries, which allows this to be used multiple times.
- Guppy's TailIncreases chance of finding gold chests and normal chests, but reduces chance of finding pickups.: Chests often contain sacks, making most gold chests pay for themselves and then some.
Afterbirth item and trinket concepts, including Sack Head.