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Issues: Incomplete list of additions and changes.

The Binding of Isaac: Afterbirth is the expansion to The Binding of Isaac: Rebirth. The DLC was released on October 30, 2015 and costs $10.99/£7.99. It was released on May 10, 2016 on Xbox One and PS4.

For a list of the pre-release blog posts, see The Binding of Isaac: Afterbirth (Pre-Release).

Contents

FeaturesEdit

AdditionsEdit

PlayerEdit

CharactersEdit

Character  
Lilith
 
Keeper
  Health       
  Damage 3.5 (*1.00) 3.5 (*1.20)
  Tears   Blindfolded
(+0)
+18
  Shot Speed   Blindfolded
(1)
1
  Range   Blindfolded
(23.75)
23.75
  Speed 1.0 0.85
  Luck 0 -2
  Starting Pickup(s) None x1 bombs
  x1 coins
    Store Key
  Starting Item(s)   Incubus
    Cambion Conception
  Box of Friends
Triple shot
    Wooden Nickel

TransformationsEdit

Name Appearance Description Items
Bob  

Isaac gains a green trail of poisonous creep.

Conjoined  

When attacking, the tumor faces shoot tears diagonally outwards, similar to the effect of    The Wiz. Also gives -0.3 damage and slightly decreases tears.

Fun Guy  

+1 Red Heart container.

Leviathan  

Grants flight and gives +2 black hearts.

Oh Crap  

Whenever a pile of poop is destroyed, health is replenished by half a heart.

Seraphim  

Grants flight and gives +3 soul hearts.

Spun  

Gives +2 damage and +0.15 speed, and spawns a random pill upon transformation.

Super Bum  

Replaces   Bum Friend,   Dark Bum, and    Key Bum for Super Bum. This bum collects any of the other beggars' pickups, and offers twice the rewards.

Yes Mother?  

Isaac gains a stationary knife that trails directly behind him. It synergizes like   Mom's Knife would.

1: Image depicts the familiar. This transformation does not alter Isaac's appearance.

Co-opEdit

Special Babies

These Babies have special bonuses that will aid the player in some way.

ID Appearance Name Description
27   Black Baby Spawns with an extra black heart.
  Defeat Mega Satan as Azazel to unlock it.
28   Red Baby Spawns with an extra red heart.
  Defeat Mega Satan as Magdalene to unlock it.
29   White Baby Gives Isaac an eternal heart when it spawns.
  Defeat Mega Satan as The Lost to unlock it.
30   Blue Baby Spawns with an extra soul heart.
  Defeat Mega Satan as ??? to unlock it.
31   Rage Baby Occasionally briefly increases Isaac's damage.
  Defeat Mega Satan as Samson to unlock it.
32   Cry Baby Occasionally briefly increases Isaac's tears.
  Defeat Mega Satan as Isaac to unlock it.
33   Yellow Baby Occasionally briefly increases Isaac's speed by 0.15.
  Defeat Mega Satan as Eden to unlock it.
34   Long Baby Occasionally briefly increases Isaac's range, shot speed, and tear height.
  Defeat Mega Satan as Lazarus to unlock it.
35   Green Baby Occasionally briefly increases Isaac's luck by 2.
  Defeat Mega Satan as Cain to unlock it.
36   Lil' Baby Occasionally briefly decreases Isaac's size.
  Defeat Mega Satan as Eve to unlock it.
37   Big Baby Occasionally briefly increases Isaac's size.
  Defeat Mega Satan as Lilith to unlock it.
38   Brown Baby Occasionally briefly gives Isaac the   Butt Penny effect. While it is active, picking up a coin will make Isaac fart, knocking back nearby enemies.
  Defeat Mega Satan as Judas to unlock it.
39   Noose Baby Occasionally briefly gives Isaac the   Transcendence effect, granting flight.
  Defeat Mega Satan as Keeper to unlock it.
40   Hive Baby Occasionally briefly gives Isaac the   Hive Mind effect, doubling the damage dealt by blue spiders and blue flies.
  Earn all Hard mode completion marks as ??? to unlock it.
41   Buddy Baby Occasionally briefly gives Isaac the   Guillotine effect, detaching Isaac's head and increasing damage and tears.
  Earn all Hard mode completion marks as Isaac to unlock it.
42   Colorful Baby Upon joining, fully heals Isaac, similar to the rainbow poop effect.
  Earn all Hard mode completion marks as Magdalene to unlock it.
43   Whore Baby Occasionally briefly gives Isaac the   Whore of Babylon effect, increasing damage and speed.
  Earn all Hard mode completion marks as Eve to unlock it.
44   Cracked Baby
  Earn all Hard mode completion marks as Eden to unlock it.
45   Dripping Baby Occasionally briefly gives Isaac   Anemic, increasing range by 5 and causing Isaac to leave a trail of blood that damages enemies.
  Earn all Hard mode completion marks as Lazarus to unlock it.
46   Blinding Baby Upon death, activates the effect of XIX - The Sun, fully restoring Isaac's red hearts, deals 100 damage to all enemies in the room, and revealing the map for the current floor.
  Use   Blank Card while holding   XIX - The Sun to unlock it.
47   Sucky Baby Has an aura around itself that damages enemies while they are inside, similar to   Succubus.
  Earn all Hard mode completion marks as Azazel to unlock it.
48   Dark Baby Occasionally provides a brief boost to all of Isaac's stats.
  Earn all Hard mode completion marks as Lilith to unlock it.
49   Picky Baby
  Earn all Hard mode completion marks as Cain to unlock it.
50   Revenge Baby Occasionally briefly increases Isaac's damage.
  Earn all Hard mode completion marks as Samson to unlock it.
51   Belial Baby Occasionally briefly gives Isaac the   The Book of Belial effect, increasing damage.
  Earn all Hard mode completion marks as Judas to unlock it.
52   Sale Baby Occasionally briefly gives Isaac the   Steam Sale effect, halving the prices of all shop items.
  Earn all Hard mode completion marks as Keeper to unlock it.
53   Goat Head Baby Occasionally briefly gives Isaac the   Goat Head effect, guaranteeing that a Devil room or angel room will open if a boss room is completed while the effect is active.
  Defeat Mom's Heart on Hard mode as Lilith to unlock it.
54   Super Greed Baby Has the Head of the Keeper effect, firing coin tears that have a chance to spawn a coin upon hitting an enemy.
  Defeat Mom's Heart on Hard mode as Keeper to unlock it.

Normal Babies

These Babies are purely cosmetic and do not have any special behaviors.

ID Appearance Name Description
233   Punkboy Baby A baby dressed as a punk rocker boy.
234   Punkgirl Baby A baby dressed as a punk rocker girl.
235   Computer Baby A baby with a computer for a head.
236   Mask Baby A baby wearing a mask.
237   Gem Baby A baby that looks like it's made of crystal.
238   Shark Baby A baby that looks like a shark.
239   Beret Baby A baby that's wearing a beret.
240   Blisters Baby A baby covered in blisters.
241   Radioactive Baby A sickly green baby.
242   Beast Baby A baby that looks like a beast.
243   Dark Baby A very dark baby.
244   Snail Baby A baby that looks like a snail.
245   Blood Baby A baby that looks like a drop of blood.
246   8 Ball Baby A baby with an 8 ball for a head.
247   Wisp Baby A wispy baby.
248   Cactus Baby A baby that looks like a cactus.
249   Love Eye Baby A pink baby with a heart for an eye.
250   Medusa Baby A baby that resembles Medusa.
251   Nuclear Baby A baby that looks like a mushroom cloud.
252   Purple Baby A strange purple baby.
253   Wizard Baby A baby with a wizard hat.
254   Earth Baby A baby whose head looks like planet Earth.
255   Saturn Baby A baby with a ring around its head.
256   Cloud Baby A baby made of cloud.
257   Tube Baby A baby with a tube connecting both eyes.
258   Rocker Baby A baby dressed as a rock fan.
259   King Baby A baby with a crown.
260   Coat Baby A baby wearing a winter coat.
261   Viking Baby A baby with a Viking helmet.
262   Panda Baby A baby that looks like a panda.
263   Raccoon Baby A baby that looks like a raccoon.
264   Bear Baby A baby that looks like a grizzly bear.
265   Polar Bear Baby A baby that looks like a polar bear.
266   Lovebear Baby A baby that looks like a Care Bear.
267   Hare Baby A baby that looks like a rabbit.
268   Squirrel Baby A baby that looks like a squirrel.
269   Tabby Baby A baby that looks like a cat.
270   Porcupine Baby A baby that looks like a porcupine.
271   Puppy Baby A baby that looks like a puppy.
272   Parrot Baby A baby that looks like a parrot.
273   Chameleon Baby A baby that looks like a Chameleon.
274   Boulder Baby A baby made of rocks.
275   Aqua Baby An aqua-blue baby.
276   Gargoyle Baby A baby that resembles a gargoyle.
277   Spiky Demon Baby A baby that looks like a spiky demon.
278   Red Demon Baby A baby that looks like a red demon.
279   Orange Demon Baby A baby that looks like an orange demon.
280   Eye Demon Baby A baby with an eye for a head.
281   Fang Demon Baby A baby with big fangs.
282   Ghost Baby A baby that looks like a ghost.
283   Arachnid Baby A baby that looks like a spider.
284   Bony Baby A baby that looks like a Bony.
285   Big Tongue Baby A baby with a big tongue.
286   3D Baby A baby wearing 3D glasses.
287   Suit Baby A baby in a nice suit.
288   Butt Baby A baby with a butt for a face.
289   Cupid Baby A baby that looks like Cupid.
290   Heart Baby A baby with a heart-shaped head.
291   Killer Baby A baby that looks like Jason Voorhees from the "Friday the 13th" horror movie series.
292   Lantern Baby A baby that looks like Ash Williams from the Evil Dead series.
293   Banshee Baby A baby that looks like a banshee.
294   Ranger Baby A baby that looks like a Red Power Ranger.
295   Rider Baby A baby that looks like a Kamen Rider.
296   Choco Baby A baby made of chocolate.
297   Woodsman Baby A baby dressed as a hiker.
298   Brunette Baby A baby with brown hair
299   Blonde Baby A baby with blonde hair.
300   Blue Hair Baby A baby with blue hair
301   Bloodied Baby A baby covered in blood.
302   Cheese Baby A baby made of cheese.
303   Pizza Baby A baby made of pizza.
304   Hotdog Baby A baby that is also a hotdog.
305   Nature Baby A naked baby with a leaf.
306   Borg Baby A robotic baby.
307   Corrupted Baby A baby with seems to be covered by an alien life.
308   X Mouth Baby A gagged baby.
309   X Eyed Baby A comically dead baby.
310   Starry Eyed Baby A baby with starry eyes.
311   Surgeon Baby A baby ready for surgery.
312   Sword Baby A baby that's a sword.
313   Monk Baby A baby that's a monk.
314   Disco Baby A funky baby with an afro
315   Puzzle Baby A baby with a "Rubik's Cube" for a head
316   Speaker Baby A baby that has a speaker for a head.
317   Scary Baby A baby that resembles Jeff the Killer.
318   Fireball Baby A fireball with eyes. Possibly a reference to the fire enemy in the Donkey Kong and Mario games.
319   Maw Baby A baby that's just a mouth.
320   Exploding Baby A baby that's a bomb.
321   Cupcake Baby A baby that's also a cupcake.
322   Skinless Baby A baby without skin.
323   Ballerina Baby A baby wearing a tutu.
324   Goblin Baby A baby that resembles a goblin.
325   Cool Goblin Baby A green baby with brown hair and cool shades.
326   Geek Baby A baby with black hair and nerdy glasses.
327   Long Beard Baby A baby with a long beard.
328   Muttonchops Baby A baby with muttonchops.
329   Spartan Baby A baby that resembles King Leonidas from 300.
330   Tortoise Baby A baby that looks like a tortoise.
331   Slicer Baby A baby that resembles Shredder.
332   Butterfly Baby A baby with butterfly wings.
333   Homeless Baby A baby that resembles a homeless person.
334   Lumberjack Baby A baby that resembles a lumberjack.
335   Cyberspace Baby A baby that resembles something from the Tron universe.
336   Hero Baby A baby that resembles Red from Gunstar Heroes.
337   Boxers Baby A baby that resembles Arthur from Ghosts & Goblins (in his boxers).
338   Wing Helmet Baby A baby that resembles Opa-Opa.
339   X Baby A baby with an X for a head.
340   O Baby A baby with an O for a head.
341   Vomit Baby A baby with vomit coming from its mouth.
342   Merman Baby A baby that resembles Aquaman.
343   Cyborg Baby Might be a reference to a Cyborg from a novel/movie/game?
344   Barbarian Baby A baby that resembles the Barbarian from Diablo.
345   Locust Baby A baby that resembles a locust.
346   Twotone Baby A completely white baby with a black outline.
347   2600 Baby A baby that resembles an Atari 2600 sprite.
348   Fourtone Baby A baby with a minimal colour sprite.
349   Grayscale Baby A baby colored with several shades of gray.
350   Rabbit Baby A baby that resembles Oswald the Lucky Rabbit.
351   Mouse Baby A baby that resembles an old-style Mickey Mouse.
352   Critter Baby A critter that looks white and hairy. Might be a reference to the movie Critters.
353   Blue Robot Baby A baby that resembles Mega Man.
354   Pilot Baby A baby that resembles Jason from Blaster Master.
355   Red Plumber Baby A baby that resembles Mario.
356   Green Plumber Baby A baby that resembles Luigi.
357   Yellow Plumber Baby A baby that resembles Wario.
358   Purple Plumber Baby A baby that resembles Waluigi.
359   Tanooki Baby A baby that's wearing a Tanooki Suit.
360   Mushroom Man Baby A baby that resembles Toad.
361   Mushroom Girl Baby A baby that resembles Toadette.
362   Cannonball Baby A baby that resembles a Chain Chomp.
363   Froggy Baby A baby that's wearing a Frog Suit.
364   Turtle Dragon Baby A baby that resembles Bowser.
365   Shell Suit Baby A baby wearing a Hammer Suit.
366   Fiery Baby A baby wearing a Fire Suit.
367   Mean Mushroom Baby A baby that resembles a Goomba.
368   Arcade Baby A baby that resembles Pac-Man.
369   Scared Ghost Baby A blue ghost with a scared expression.
370   Blue Ghost Baby A baby that resembles Inky.
371   Red Ghost Baby A baby that resembles Blinky.
372   Pink Ghost Baby A baby that resembles Pinky.
373   Orange Ghost Baby A baby that resembles Clyde.
374   Pink Princess Baby A baby that resembles Princess Peach.
375   Yellow Princess Baby A baby that resembles Princess Daisy.
376   Dino Baby A baby that resembles Yoshi.
377   Elf Baby A baby that resembles Link.
378   Dark Elf Baby A baby that resembles Dark Link
379   Dark Knight Baby A baby that resembles a Darknut
380   Octopus Baby A baby that resembles an Octorok.
381   Orange Pig Baby A baby that resembles an orange Moblin.
382   Blue Pig Baby A baby that resembles a blue Moblin.
383   Elf Princess Baby A baby that resembles Princess Zelda.
384   Fishman Baby A baby that resembles a Zora.
385   Fairyman Baby A baby that resembles Tingle.
386   Imp Baby A baby that resembles Midna.
387   Worm Baby A baby that resembles Earthworm Jim.
388   Blue Wrestler Baby A baby that looks like the blue player in Smash TV.
389   Red Wrestler Baby A baby that looks like the red player in Smash TV.
390   Toast Baby A baby that resembles Powdered Toast Man.
391   Roboboy Baby A baby that resembles Astro Boy.
392   Liberty Baby A baby that resembles the Statue of Liberty.
393   Dream Knight Baby A baby that resembles Meta Knight.
394   Cowboy Baby A baby that's wearing a cowboy outfit.
395   Mermaid Baby A baby that resembles Ariel.
396   Plague Baby A baby wearing a plague doctor outfit.
397   Space Soldier Baby A baby that resembles a Warhammer 40k Space Marine.
398   Dark Space Soldier Baby A baby that resembles a Warhammer 40k Chaos Space Marine.
399   Gas Mask Baby A baby that's wearing a gas mask.
400   Tomboy Baby A baby that resembles Sheik from the Legend of Zelda franchise.
401   Corgi Baby A baby that looks like a corgi.
402   Unicorn Baby A baby that looks like a unicorn.
403   Pixie Baby A baby that resembles Tinkerbell.
404   Referee Baby A baby wearing a referee outfit.
405   Deal With It Baby A baby with a goatee and sunglasses.
406   Astronaut Baby A baby that's wearing an astronaut outfit.
407   Blurred Baby A baby with a blur effect across its privates.
408   Censored Baby A baby with a censor bar across its privates.
409   Cool Ghost Baby A baby that resembles the character Shades (Sukezaemon) from Ufouria: The Saga.
410   Gills Baby A baby that resembles the character Gil (Jennifer) from Ufouria: The Saga.
411   Blue Hat Baby A baby that resembles the character Bop-Louie (Hebe) from Ufouria: The Saga.
412   Catsuit Baby A baby that's wearing a cat outfit. Also resembles the character Oh-Chan from Ufouria: The Saga (Japanese version).
413   Pirate Baby A baby that's wearing a pirate outfit.
414   Super Robo Baby A baby that resembles Tekkaman the Space Knight.
415   Lightmage Baby A baby that resembles the white mage class from Final Fantasy.
416   Puncher Baby A baby that resembles the warrior class from Final Fantasy.
417   Holy Knight Baby A baby that resembles the monk class from Final Fantasy.
418   Shadowmage Baby A baby that resembles the black mage class from Final Fantasy.
419   Firemage Baby A baby that resembles the red mage class from Final Fantasy.
420   Priest Baby A baby that's wearing a priest outfit.
421   Zipper Baby A baby with a zipped mouth.
422   Bag Baby A baby with a bag over its head.
423   Sailor Baby A baby that's wearing a sailor outfit.
424   Rich Baby A baby with a top hat and monocle.
425   Toga Baby A baby in an ancient Roman outfit.
426   Knight Baby A baby that resembles a Darknut from The Legend of Zelda.
427   Black Knight Baby A baby that resembles a black Darknut from The Legend of Zelda.


ItemsEdit

95 new items were added in the expansion: 19 activated items and 76 passive items.

Activated CollectiblesEdit

Name ID Icon Quote Description
Box of Friends 357
 
Double your friends Upon use, duplicates all of Isaac's familiars for the current room.
D12 386
 
Rerolls rocks Re-rolls all rocks in the current room into other random objects, such as bomb rocks, metal blocks, TNT, or poops.
D7 437
 
Reroll rewards! Restarts the current room and brings back all enemies, allowing more rewards to be acquired by completing the room.
D8 406
 
Reroll stats Re-rolls Isaac's speed, range, tears, and damage.
Diplopia 347
Double item vision Duplicates all pickups and item pedestals in the room.
Friendly Ball 382
 
Gotta fetch 'em all! Throwing the ball at an enemy instantly kills it and captures it. The captured enemy can later be released and will be friendly, fighting for Isaac and persisting between rooms.
Glass Cannon 352
 
Be gentle... Reduces Isaac's health to half a heart (including Soul and Black Hearts) and fires a large piercing spectral tear that does very high damage.
Glowing Hour Glass 422
 
Turn back time When used, this item will rewind time, put Isaac back in the previous room, and undo anything that happened in the current room. Any health, pickups, or items gained or lost will be reset back to the previous state.
Jar of Flies 434
Gotta catch 'em all? Every time Isaac kills an enemy, a fly will be added to the jar, up to a maximum of 20. Using the Jar of Flies will release all the flies that are currently in the jar as friendly blue flies that will damage enemies.
Kidney Bean 421
 
Love toots! Upon use, Isaac farts, charming all nearby enemies.
Mega Bean 351
 
Giga fart! Freezes all enemies in the current room for a couple of seconds, poisons any enemies near Isaac, and sends a rock wave across the room in the direction Isaac is facing.
Mega Blast 441
 
Laser breath Upon use, Isaac fires a laser similar to the one used by Mega Satan. This laser deals massive damage, lasts for approximately 15 seconds, and persists between rooms. Isaac is pushed backwards by the force of the laser while it is active.
Mine Crafter 427
 
Booom! Places an explosive TNT barrel that can be pushed and used to destroy rocks or damage enemies when used. If used a second time in the same room while the previous TNT barrel is still intact, it will remotely explode the TNT.
Mom's Box 439
 
What's inside? When used, Mom's Box will drop a random trinket on the ground. While held, increases luck by 1 and doubles the effects of trinkets.
Placebo 348
 
Pill mimic When used, copies the effect of the pill Isaac is currently holding without consuming it. Does not copy the effects of cards or runes.
Tear Detonator 383
 
Remote tear detonation! When used, will detonate any tears currently on the screen and cause each one to split into 6 more tears which will fire in a circle, similar to Tammy's Head.
Teleport 2.0 419
 
I-Teleport! Teleports Isaac to a random room that has not been explored yet when used. If all rooms are explored, including secret rooms, it will teleport Isaac to the Devil or Angel room. If all rooms are explored, including the Devil or Angel room, it will teleport Isaac to the I AM ERROR room. If used in a room with enemies, it will teleport Isaac out and back into the same room.
Ventricle Razor 396
Short cutter Can be used to place an orange portal and a blue portal. Upon entering a portal, Isaac is teleported to the other portal.
Wooden Nickel 349
 
Flip a coin When used, has a 50% chance to drop one random type of coin (Penny, Nickel, or Dime).

Passive CollectiblesEdit

Name ID Icon Quote Description
8 Inch Nails 359   Stick it to 'em! +1.5 Damage Up. Replaces Isaac's tears with nails, which have increased knockback.
Athame 408   Call to the void Whenever Isaac takes damage, a black ring briefly appears around Isaac, dealing damage to all nearby enemies.
Betrayal 391   Turn your enemy Every time Isaac takes damage, a charm effect is applied to every enemy in the room, causing them to attack each other rather than Isaac.
Binky 438   Memories... Tears up, adds 1 Soul Heart, and decreases Isaac's size.
Black Powder 420   Spin the black circle! Isaac leaves a trail of black powder on the floor. Walking in a circle will spawn a pentagram symbol on the floor, which deals 10 damage per tick to any enemies inside it.
Bomber Boy 353   Explosive blast! +5 bombs. Isaac's bombs will now explode in a large cross-shaped pattern (roughly 5 bombs explosions wide). This also affects player-spawned Troll Bombs.
Bumbo 385   Bumbo want coin! Spawns a Beggar familiar which floats around the room and picks up any nearby coins, leveling up after collecting several coins. At level 2, Bumbo gains a body. At level 3, it begins to fire tears. At level 4, Bumbo chases enemies slowly, doing contact damage.
Bursting Sack 377   Spider love Spider enemies no longer target or deal contact damage to Isaac.
Cambion Conception 412   Feed them hate After taking damage a certain amount of times, a permanent demonic familiar spawns.
Car Battery 356   Double charge! Causes Isaac's activated item to activate twice on each use.
Censer 387   Peace be with you Gives Isaac a golden censer familiar which creates a huge aura of light that slows down any enemies and enemy shots inside it.
Chaos 402   !!! Chaos causes items to be chosen from random item pools. When picked up, drops between 1-6 random pickups on the floor.
Charged Baby 372   Bbbzzzzzt! A battery familiar that occasionally drops a Lil' Battery, gives an active item charge, or freezes all enemies in the room.
Circle of Protection 423   Protect me from myself Surrounds Isaac with a large white halo. Once per second, the halo deals Isaac's tear damage to enemies inside it. It may also convert enemy shots entering the halo into friendly purple homing tears.
Continuum 369   Transcendent tears +2.25 range up. +1.5 tear height. Isaac's tears travel through walls and appear out of the opposite wall. Isaac's tears also travel over rocks and objects.
Crack Jacks 354   Don't swallow the prize! Adds one Red Heart container and drops a random trinket.
Crown of Light 415   The untainted gain power +2 soul hearts. While Isaac has no damaged red heart containers, grants diamond tears that deal double damage and have increased range and reduced shot speed. Regardless of health, the crown will deactivate for the current room when Isaac takes damage.
Curse of the Tower 371   You feel cursed... Causes Isaac to spawn 6 Troll Bombs on the floor every time he gets hit, similar to the   Anarchist Cookbook mechanic.
Dead Eye 373   Accuracy brings power! Isaac's damage increases each time an enemy is hit. Damage is reset upon missing a shot.
Deep Pockets 416   More stuff to carry! Allows Isaac to carry two cards or pills (or a combination of both) at the same time.
Eden's Blessing 381   Your future shines brighter +0.7 tears up. Grants a random item at the start of the next run.
Empty Vessel 409   I reward an empty vessel While Isaac has no red hearts, this item grants flight and a random chance to activate an invincibility shield for a few seconds. If Isaac gains any Red Hearts, these benefits will disappear.
Epiphora 368   Intensifying tears Shooting in one direction increases Isaac's rate of fire until the cap is reached. As soon as Isaac changes direction or stops shooting, rate of fire is reset to its normal amount.
Evil Eye 410   Eye shot! While firing tears, Isaac has a chance to fire an eye across the screen with a very slow shot speed, which will fire tears of its own in the same direction as Isaac. The eye will be destroyed if it comes into contact with an enemy or obstacle.
Explosivo 401   Sticky bomb shot! Isaac's tears have a chance to stick to enemies and explode.
Farting Baby 404   It farts! A familiar that follows Isaac and blocks tears. If a tear hits Farting Baby, there is a high chance for it to fart, which will either knockback, poison, or charm all nearby enemies.
Fate's Reward 361   Your fate beside you A blue head familiar that will follow Isaac and fire tears copying his tear effects and damage.
Friend Zone 364   Friendly fly A white orbiting fly which deals 3 contact damage per tick to enemies. This familiar orbits Isaac at a middle length distance somewhere between   Distant Admiration and   Forever Alone.
Fruit Cake 418   Rainbow effects! Isaac's tears gain a random effect that changes every shot.
GB Bug 405   Game breaking bug, right away! A glitch familiar that bounces around the room and applies a random status effect to any enemies it comes into contact with and has a chance to re-roll pickups that it passes over.
Glitter Bombs 432   Prize bombs! Gives Isaac 5 bombs, and makes Isaac's bombs have a chance to drop random pickups or charm enemies when they explode.
God's Flesh 398   Shrink shot Tears now have a random chance to apply a shrinking effect, causing enemies to shrink in size and also run away from Isaac. Shrunk enemies can be crushed and killed by walking over them.
Head of the Keeper 429   Penny tears! Isaac's tears become coins and now have a chance to drop Pennies on the floor upon successfully hitting an enemy.
Holy Light 374   Holy shot! Isaac has a random chance to fire a Holy tear, which, when it hits an enemy, will spawn a Crack the Sky-style light beam on the same enemy, dealing damage.
Host Hat 375   Nice hat! A host familiar that sits on Isaac's head and has a random chance to block enemy shots and retaliate with 3 tears. Grants immunity to explosions.
Immaculate Conception 413   Feed them love Upon picking up a certain amount of health, spawn a permanent angelic familiar.
Incubus 360   Dark friend A demonic familiar that follows Isaac and shoots tears identical to Isaac's in terms of damage, range, fire rate, and effects.
Key Bum 388   He wants your keys! Spawns a portable key master that follows Isaac and collects keys, giving random chests in return.
Kidney Stone 440   Matt's kidney stone Randomly while firing tears, Isaac will stop firing and turn red, where he will charge and release a lot of 'tears' in one go. In the burst of tears is a kidney stone which deals a lot of damage.
Lil Chest 362   What's in the box? Spawns a chest familiar that follows Isaac and drops a random pickup every few rooms.
Lil Gurdy 384   A gurd of your own! Gives Isaac a Gurdy familiar that will charge around the room dealing contact damage to enemies. Lil Gurdy is charged by holding down a fire button and letting go. The longer the button is held, the faster Lil Gurdy will fling itself across the screen. Lil Gurdy can pass over objects and obstacles in the room.
Lil' Loki 435   4-way buddy! A Loki familiar that follows Isaac and shoots 4 tears in a cross pattern.
Lost Fly 365   Lost protector A familiar fly that moves in a straight line and attaches itself to the first obstacle or wall it comes into contact within each room. If any enemies walk into its path, it will do 7 contact damage per tick. If the obstacle it is attached to is destroyed then it will continue rolling in the direction it was previously traveling until it meets another wall or obstacle.
Lusty Blood 411   Their blood brings rage! Each time Isaac kills an enemy, Isaac's damage increases for the current room.
Marked 394   Directed tears Isaac will now fire tears automatically directed at a red target on the ground which is controlled by the player. This allows for a full 360-degree tear firing radius. It can be overridden by other tear modifiers such as Mom's Knife or Brimstone.
Maw of the Void 399   Consume thy enemy! +1.0 Damage Up. After continuously firing tears for 2.5 seconds, a red cross appears on Isaac's head that, upon releasing the fire button, creates a black ring that rapidly deals damage equal to Isaac's tear damage to any enemies in contact with it.
Milk! 436   Don't cry over it... A glass of milk follows Isaac and spills on the floor upon taking damage. After the milk spills, Isaac's tear delay is decreased by 2 for the rest of the room.
Mom's Pearls 355   Range + luck up +1.25 Range Up. +0.5 Tear Height. +1 Luck Up.
More Options 414   There are even more options! Two items spawn in every Treasure Room. Only one can be taken; the other will disappear.
Mr. Dolly 370   Range + tears up Tears and Range up. Spawns 3 random types of hearts on the floor when picked up.
Multidimensional Baby 431   ydduB Buddy Spawns a familiar that will follow Isaac's movements on a 2.5-second delay. Tears that pass through the baby will be doubled and increase in speed.
My Shadow 433   Me! And my shaaaadow! Each time Isaac takes damage, inflicts fear on all enemies in the room and spawns a black friendly Charger that will attack enemies. The Charger will be killed if it is damaged too much.
Night Light 425   Scared of the dark? A cone of light shines in the direction Isaac is moving that slows enemies and enemy shots.
No. 2 378   Uh oh... Continuously firing tears for several seconds causes Isaac to drop a Butt Bomb. Butt Bombs explode for 60 damage like normal bombs, but also deal 10 damage to all enemies in the room and daze them for a short period of time.
Obsessed Fan 426   Follows my every move... A purple fly familiar that follows Isaac's movements on a 3 second delay and deals contact damage to enemies.
Papa Fly 430   Turret follower A blue fly familiar follows Isaac's movements on a 3 second delay. Papa Fly will fire tears at nearby enemies.
Pay to Play 380   Money talks +5 coins. Turns all doors that require a single key into doors which need a coin to enter instead. This affects shops, item rooms and libraries.
PJs 428   You feel cozy Grants four soul hearts and fully restores Isaac's red health.
Pupula Duplex 379   Wide shot Gives Isaac spectral tears and gives his tears a wide arc shape, increasing their size.
Purity 407   Aura stat boost Boosts one of Isaac's stats depending on the color of the aura around him. The aura disappears upon taking damage and reappears with a random color upon entering a new room. Red boosts damage, blue boosts tears, yellow boosts speed, and orange boosts range.
Restock 376   Never ending stores! Causes shops to instantly restock their items when they are bought. Granted by default for every character in Greed Mode.
Rune Bag 389   Rune generator A bag that follows Isaac and drops a random rune every 5-6 rooms.
Sack Head 424   More sacks! 1/3 of all pickups not spawned by sacks become sacks.
Scatter Bombs 366   We put bombs in your bombs! Adds 5 bombs. Isaac's bombs explode into 2-4 tiny bombs.
Seraphim 390   Sworn friend An angel familiar which follows Isaac and fires homing tears which deal 10 damage and have -25% shot speed.
Serpent's Kiss 393   The kiss of death Tears have a random chance to apply a poison effect to enemies. Isaac now deals poison damage on contact. Enemies that were poisoned have a chance to drop a black heart when killed.
Spear of Destiny 400   Your destiny In addition to tears, Isaac now holds a spear in front of him which deals damage equal to 2 times his tear damage, and occasionally inflicts fear. The spear cannot be thrown but deals damage while it is in contact with an enemy.
Spider Mod 403   Mod buddy! Displays Isaac's tear damage and enemy health bars. Spawns a gray spider familiar that wanders around and inflicts a random status effect on any enemies it comes into contact with. Occasionally spawns a blue spider upon clearing a room.
Sticky Bombs 367   Egg sack bombs! +5 bombs. Bombs stick to enemies and spawn 2-4 Blue Spiders if they kill an enemy.
Succubus 417   Damage booster Spawns a flying familiar that bounces around the room with a black aura, dealing rapid damage to any enemies inside it. While standing in the aura, Isaac gains a 1.5x tear damage multiplier.
Sworn Protector 363   Protective friend An orbital angel which does 7 contact damage per tick and attracts and blocks enemy shots. Upon blocking 10 shots in a room it drops an Eternal Heart.
Tech X 395   Laser ring tears Tears are replaced with laser rings that pierce through enemies and deal damage to enemies within them. Can be charged to increase the size of the ring.
The Wiz 358   Double wiz shot! Tears simultaneously fire out of both eyes diagonally, similar to the effect of the R U A Wizard? pill. Isaac's tears also travel above all obstacles.
Toxic Shock 350   Mass poison Upon entering a room, poisons all enemies, dealing double Isaac's tear damage. Killing enemies leaves a small, short lasting pool of green creep on the ground.
Tractor Beam 397   Control your tears Increases tears, range, and shot speed. Isaac emits a beam from his face that his tears follow along.
Zodiac 392   The heavens will change you Gives Isaac a random zodiac item effect that changes every floor.

TrinketsEdit

29 new trinkets were added in the expansion.

Name ID Icon Quote Description
Black Feather 80   With darkness comes power Increases Isaac's damage for possessing certain evil items.
Blasting Cap 73   Pop! Pop! Exploding bombs have a chance to drop another Bomb pickup.
Blind Rage 81   Blind to damage Increases invincibility time after getting hit.
Blister 77   Bounce back! Increases knockback of tears.
Bob's Bladder 71   Creepy bombs Leaves a pool of green creep under all bombs Isaac places, which damages enemies that walk over it.
Brown Cap 90   Fartoom! Poop blocks will explode after being destroyed.
Child Leash 89   Keep your friends close... Causes familiars to stay closer to each other.
Cracked Dice 67   You feel cursed... kinda. Activates the effect of   The D6,    D8,    D12, or   D20 whenever Isaac takes damage.
Endless Nameless 79   I'm stuck in a loop... Has a 25% chance of creating a duplicate of any pill, card, or rune Isaac uses.
Error 75   Effect not found? Gives a random trinket effect each room.
Faded Polaroid 69   You feel faded Occasionally causes Isaac to blend into the ground, which briefly confuses all enemies in the room.
Golden Horse Shoe 82   Feel lucky? +15% chance for a Treasure Room with two items to spawn.
Karma 85   Karma up Donating to a donation machine has a chance to heal Isaac for a full red heart or spawn a beggar. Increases the chance that donating to a Donation Machine will increase Isaac's luck.
Lazy Worm 66   Pft Increases Range by 4 and decreases Shot Speed by .4.
Lil Larva 86   The poop is moving... Spawns a blue fly from every pile of poop that Isaac destroys.
Louse 70   Itchy, tasty... Occasionally spawns a blue spider.
Mom's Locket 87   You feel her love Grants half a red heart each time a key is used. Converts half red heart pickups into full red hearts.
NO! 88   Never again! Prevents active items from being generated, if possible.
Poker Chip 76   It's double down time! Chests have a 50% chance of paying out with extra pickups and a 50% chance of paying out with nothing or enemies.
Rainbow Worm 64   Bleep Bloop Blop Isaac's tears gain a worm effect that changes every 3 seconds.
Rib of Greed 84   Feels greedy Prevents Greed and Super Greed from appearing in shops and secret rooms, and makes coin drops after clearing rooms more likely.
Safety Scissors 63   Fuse Cutter Troll bombs turn into Bomb pickups before they explode. Mega troll bombs turn into 1+1 free bombs before they explode.
Second Hand 78   Extended stat effect time! Increases the time that status effects stay on enemies.
Shiny Rock 62   It shines for its brothers Tinted rocks and rocks with crawl spaces flash white upon entering the room and every 10 seconds afterward.
Store Key 83   Stores are open Shops can be opened without using keys.
Stud Finder 74   The ground below feels hollow... Increases the chance to find a Crawl Space.
Super Magnet 68   It Pulls Pulls enemies and pickups towards Isaac.
Tape Worm 65   Floooooooooop! Doubles Isaac's range and halves his tear height.
Watch Battery 72   Lil charge Increased chance of batteries spawning. Has a chance to add an extra charge to Isaac's activated item upon completing a room.

PickupsEdit

HeartsEdit

Heart Image Worth Additional Info Unlocked By
Gold Heart     When a Gold Heart is lost, a few coins will be dropped around you.   Complete XXXXXXXXL (challenge #21)

CoinsEdit

Coin Image Worth Additional Info Unlocked By
Lucky Penny   1

Increases luck by 1 when picked up.

  Donate 1 coin to the Greed Donation Machine
Sticky Nickel   5

Will flip upside-down when Isaac tries to collect it. Afterwards, it will get stuck on the ground, unable to be picked up unless blasted off the ground with an explosion.

  Complete the Boss Rush as Keeper

BombsEdit

Bomb Image Worth Additional Info Unlocked By
Gold Bomb  

Will not add to the player's bomb count, but when picked up, it will give the player unlimited bombs for the duration of the current floor, even if the current number of bombs is 0.

  Complete Blue Bomber (challenge #23)

PillsEdit

ID Pill Effect
28   Percs!

Gives   The Wafer effect while in the room. Unlocked by completing Challenge #24: PAY TO PLAY.

29   Addicted!

Makes Isaac take a full heart of damage from all sources for the current room. Unlocked by completing Challenge #24: PAY TO PLAY.

30   Re-Lax

For a short time, poop spawns wherever Isaac moves, like Explosive Diarrhea but with poop. A higher move speed means you can touch more tiles in the same time. A pun on laxatives. Unlocked by completing Challenge #25: Have a Heart.

31   ???

Gives the Curse of the Maze effect for the remainder of the floor. The effect can stack with other curses. If no other curses are active for the floor, Curse of the Maze will appear under the level name when TAB is held. This effect cannot be negated by   Black Candle. Unlocked by completing Challenge #25: Have a Heart.

32 One makes you larger

Increases Isaac's size and decreases the pitch of his voice. This effect does not increase the size of Isaac's hitbox. These pills contribute to the Stompy transformation.

33 One makes you small

Decreases Isaac's size and increases the pitch of his voice. This effect decreases the size of Isaac's hitbox.

34 Infested!

Destroys all poop in the room and spawns a single Blue Spider under Isaac and on each destroyed poop.

35 Infested?

Spawns Blue Spiders equal to the number of enemies in the room. If there are no enemies in the room, spawns 1-3 Blue Spiders.

36 Power Pill!

Activates an effect similar to   The Gamekid.

37 Retro Vision

Briefly pixelates the screen 3 times over 30 seconds.

38 Friends Till The End!

Spawns three blue flies.

CardsEdit

Name ID Icon Message Effect
? Card 48   Double active When used, copies the effect of Isaac's currently held activated collectible.
Get out of Jail Free Card 47   Open Sesame Upon use, opens all doors in the current room (including the golden door at The Chest / Dark Room), similar to Dad's Key.

RunesEdit

Rune ID Icon Unlock method Message Effect
Blank Rune 40   ??? Grants a random rune effect (excluding the Black Rune). Has a 25% chance to spawn another Blank Rune upon use.

ConsumablesEdit

Name ID Icon Message Effect
Dice Shard 49   D6 + D20 Upon use, activates the effects of The D6 and the D20 at the same time.
Emergency Contact 50   Help from above When used, will cause two Mom's Hands to come down and grab two random enemies.

ChestsEdit

  Eternal Chests
  • Eternal Chests are similar in appearance to Gold Chests, except they glow bright blue instead of gold, like a soul heart. They require one key to unlock, but can be reopened a random amount of times, each time requiring another key. They can be found in Angel rooms, in I AM ERROR Rooms and rarely in a normal room. Their loot is similar to Golden Chests, but there is a 25% chance they will drop nothing upon opening. If they contain nothing or an item, they will no longer be able to be reopened.
  Spiked Chests
  • Spiked Chests are purple colored chests with spikes protruding from them that will deal damage to Isaac upon opening unless he has the Holy Mantle active, which nullifies the damage, or if found in The Chest/Dark Room, where they are free to open. They can be rarely found upon completing a room or in greed mode shops. Their loot is similar to Brown Chests. Unlike other chests, they do not appear on the minimap.

SacksEdit

  Mystery sack
  • Spawns 1-4 random pickups upon touching it. It will not drop any hearts, pills or chests, and they have an increased chance to drop batteries.

EntitiesEdit

MonstersEdit

Monster Description
Flaming Gaper
 
Walks towards Isaac, dealing contact damage. Usually turns into a Pacer or a Gusher upon death.
Drowned Hive
 
Walks around the room, avoiding Isaac while spawning Drowned Chargers. Spawns a Drowned Charger upon death.
Drowned Charger
 
Slowly moves around the room, charging at Isaac when he gets in its line of sight. Explodes into four blood shots in the ordinal directions upon death.
Dank Globin
 
Chases Isaac, dealing a full heart of contact damage. Upon taking enough damage, it collapses into a pile of goo, spawns a Spider, and leaves a puddle of slowing Black Creep. Will regenerate after a short time if not killed quickly. Leaves another puddle of Black Creep upon death.
Drowned Boom Fly
 
Flies around the room diagonally, dealing touch damage. Upon death, explodes and fires four blood shots in the cardinal directions. High chance to spawn a Drowned Charger upon death.
Scarred Double Vis
 
Randomly wanders around the room. Pauses to charge and fire a Brimstone laser which fires from all four cardinal sides when Isaac gets in its line of sight.
Scarred Guts
 
Attaches itself to a wall or obstacle and rolls around it, leaving a trail of damaging Red Creep.
Scarred Para-Bite
 
Moves towards Isaac, dealing contact damage and firing a short-range blood shot at him. Can burrow underground and reappear elsewhere.
Flaming Fatty
 
Slowly walks towards Isaac. Occasionally farts, which pushes Isaac and adjacent enemies away. Has a chance to leave behind a damaging flame upon death.
Dank Death's Head
 
Moves diagonally around the room, dealing contact damage. Needs to be killed to complete the room.
Corn
 
Quickly dashes in random directions, dealing contact damage.
Brownie Corn
 
Quickly dashes in random directions, dealing contact damage.
Dank Squirt
 
Dashes towards the player and deals contact damage. Spawns 2 Clots upon death.
Rag man's Rag Ling
 
Quickly leaps towards Isaac and deals touch damage. Randomly shoots two purple shots that orbit around it.
Dart Fly
 
Flies towards Isaac and attempts to mimic his movements. Deals contact damage.
Conjoined Fatty
 
Slowly walks towards Isaac. Occasionally pauses to fart out a line of damaging Green Creep towards Isaac. Chance to turn into a regular Fatty upon death.
Blue Conjoined Fatty
 
Slowly walks towards Isaac and occasionally farts out a homing Ipecac shot at Isaac.
Fat Bat
 
Slowly flies towards Isaac. Tries to align itself diagonally to Isaac and shoots at him when in that alignment.
Imp
 
Slowly drifts towards Isaac, frequently firing 5 blood shots in quick succession towards him. Tries to avoid Isaac's shots and occasionally teleports and reappears elsewhere.
Roundy
 
Pops out of the ground in random locations, creating a small rock wave. Fires an explosive Ipecac shot at Isaac if he is in sight.
Black Bony
 
Wanders around the room and throws three bones in a row at Isaac when he is in sight. Explodes upon death.
Black Globin
 
Chases Isaac, dealing a full heart of contact damage and spawning Spiders whenever it takes damage. Spawns a Spider, a Black Globin's Head, and a Black Globin's Body upon death.
Black Globin's Head
 
Slides towards Isaac, leaving a trail of damaging Red Creep.
Black Globin's Body
 
Walks aimlessly around the room, occasionally spawning spiders.
Swarm Fly
 
Follows Isaac in large groups and deals contact damage.
Mega Clotty
 
Slowly moves around the room, occasionally hopping and either firing 6 blood shots in all directions, leaving a puddle of Red Creep, or spawning a Clotty or a collapsed Globin. Splits into two Clotties upon death.
Bone Knight
 
Moves erratically around the room, charges toward Isaac when in line of sight, and leaves behind a short-lasting trail of damaging Red Creep. Can only be damaged from behind.
Cyclopia
 
Walks towards Isaac, dealing contact damage and leaving behind a short-lasting trail of damaging Red Creep. Occasionally shoots a blood shot towards Isaac.
Red Ghost
 
Disappears, then reappears near Isaac and fires a brimstone laser.
Flesh Death's Head
 
Moves diagonally around the room, dealing contact damage. Releases 6 blood shots in all directions upon death. Can be killed, but also dies when the room is cleared.
Mom's Dead Hand
 
Falls from the ceiling. Upon landing, it spawns several rock waves that travel outwards. Spawns several spiders upon death. Entering a room containing Mom's Dead Hand will warn the player with Mom's laugh.
Dukie
 
Flies around the room diagonally, occasionally spitting out 1-2 Dart Flies.
Ulcer
 
Pops out of the ground in random locations and spawns a Dart Fly if Isaac is in sight. Fires a blood shot after spawning 6 Dart Flies.
Meatball
 
Slides around the room. If Isaac is in sight, it will stop to spew a fountain of short-range blood shots in all directions or to spit a line of damaging Red Creep towards Isaac. Spawns a Host upon death.
Pitfall
 
Invulnerable and stationary enemy which Isaac falls into when walked over, taking damage and popping back out after a short delay.
Teleport Pitfall
 
Invulnerable and stationary enemy which Isaac falls into when walked over, taking damage and popping back out at a random location after a short delay.
Suction Pitfall
 
Invulnerable and stationary enemy which sucks Isaac towards itself. Isaac falls into it when walked over, taking damage and popping back out after a short delay.
Ultra Greed Coin (Spinner)
 
Spins around the room, dealing contact damage.
Ultra Greed Coin (Key)
 
Spins on itself and opens a golden door around the room if not destroyed.
Ultra Greed Coin (Bomb)
 
Spins on itself and explodes with a large radius if not destroyed.
Ultra Greed Coin (Heart)
 
Spins on itself and heals Ultra Greed for 13.125 HP each if not destroyed.
Corn Mine
 
Goes off when destroyed or after some time, then releases a cloud of poisonous gas and fires corny shots in eight directions.
Hush Fly
 
Gathers with other Hush Flies and flies towards Isaac in certain patterns. Can also orbit Hush.
Blue Gaper
 
Walks towards Isaac, dealing contact damage.
Blue Boil
 
Stationary enemy that decreases in size when hit, but regenerates to its full size until fully destroyed. Fires 1-3 blood shots towards Isaac when fully swollen.
Greed Gaper
 
Walks towards Isaac, dealing contact damage.
Dark Ball
 
Floats towards Isaac, doing contact damage.

BossesEdit

Rag Man Little Horn Dangle Turdlings
The Frail The Stain The Forsaken Brownie
Hush Ultra Greed

BeggarsEdit

  Bomb bum

Bomb Bums are extremely rare, and ask for bombs. Each bomb donated has a chance to have him drop 1-2 bomb pickups or an item from the Bomb Bum Item Pool. After spawning a pedestal item, the Bomb Bum will disappear and can no longer be donated to.

EnvironmentEdit

ChaptersEdit

   
Burning Basement Flooded Caves
   
Dank Depths Scarred Womb
 
??? (Blue Womb)

ChallengesEdit

Name Conditions Goal Unlocked by Unlocks


ChangesEdit

PlayerEdit

CharactersEdit

Azazel
  • His mini-brimstone's range can be increased with range up items or pills.
The Lost

ItemsEdit

Activated CollectiblesEdit

  Bob's Rotten Head
  • The head deals 3 times Isaac's tear damage as poison over time instead of either 6 or 8 points.
  The Book of Belial
  • Increases the chance to open the Devil Room or Angel Room by 12.5% after killing a boss while holding it instead of guaranteeing it.
  Book of Revelations
  • Increases chance for a Devil/Angel Room Door to open by 17.5% instead of 35%.
  Butter Bean
  • Knocks back enemy shots.
  Crack the Sky
  • The beams have a high chance to directly target enemies.
  D4
  • Previously held items are removed from the pause menu.
  The D6
  • Reroll an item after defeating The Fallen no longer replace the Devil Room item he drops to a random item from the normal boss item pool.
  D10
  • Fly enemies are only rerolled into other fly enemies.
  • Red flies can't be rerolled anymore (even though enemies can be rerolled into them).
  Flush!
  • Floods the whole room with water.
  • Flushes all poop-related enemies and bosses away.
  • The ladders are covered in water but the walls are not when used inside a crawl space.
  Guppy's Paw
  • Can no longer be used without red heart containers.
  Head of Krampus
  • Has a 50% chance to rotate all beams around the player 90 degrees, similar to Krampus' second Brimstone attack.
  The Jar
  • Sprite changed.
  Monstro's Tooth
  • Does not affect if Monstro is in the room the item is used in.
  The Poop
  • Knocks back enemy shots.
  Scissors
  • Its recharge time is 2 rooms instead of 6 rooms.
  Undefined
  • Dark Room can no longer be cleared repeatedly.

Passive CollectiblesEdit

  20/20
  • Sprite changed.
  3 Dollar Bill
  • The type of randomized tear changes every 2–3 seconds. The item appears to select two tear effects at once, perhaps staggering the times at which each of those effects change.
  • If a run is quit, and then continued, 3 Dollar Bill will keep tear effects for the current room.
  Abel
  • Shoots tears towards Isaac regardless of which direction Isaac is shooting.
  Ball of Bandages
  • Blocks enemy shots.
  Bob's Brain
  • Bob's Brain is fired directly from where it is located in the chain of familiars behind Isaac, making aiming it slightly more difficult.
  • Each copy takes up its own spot on the familiar line, but only the first one launches out. Respawning brains may end up stacking on top of each other.
  Bomb Bag
  Box
  Butt Bombs
  Cain's Other Eye
  • Each tear deals Isaac's tear damage.
  The Common Cold
  • The poison hits twice, dealing a total of double Isaac's damage.
  Dr. Fetus
  • Each bomb deals 5 times the character's normal tear damage instead of 3, plus a flat 30 damage. The flat 30 is not affected by damage multipliers.
  Fire Mind
  • Isaac gives a wide glow lighting up dark areas, such as those under the effects of the Curse of Darkness or the Dark One's attacks.
  Isaac's Heart
  • Brimstone shots damage the heart.
  Leo
  • Nullifies effects of One Makes You Small pills, One Makes You Larger pills, and other items that decrease the size of Isaac, such as Caffeine Pill.
  Lost Contact
  • Gives a shield to familiar's tears.
  Lord of the Pit
  • Speed boost is applied immediately.
  Mom's Contacts
  • Range and tears height buffs are applied immediately.
  Mom's Knife
  • If picked up twice in the same run, two knives are fired at once.
  Punching Bag
  • Dies after taking too much damage and then respawns after a long time. Exiting and continuing the run will cause it to reappear right away.
  • Dies instantly by enemies' beam-type attacks, such as Uriel's and Gabriel's beam. This also includes enemies' Technology lasers such as Eye and Camillo Jr..
  • Reappears instantly each time a familiar or orbital item is picked up.
  Scorpio
  • The poison hits twice, dealing a total of double Isaac's damage.
  Steam Sale
  • Having multiple Steam Sales reduces all shop prices to 0 coins.
  • Causes the Deals with the Devil not to convert the heart-type automatically.
  Stop Watch
  • The slow is only applied after the player is hit.
  Strange Attractor
  • Isaac's bombs are magnetically attracted to the player character's tears.
  Tech.5
  The Virus
  • Each poison hit deals damage equal to Isaac's tear damage instead of 4 or 6 damage.
  • Enemies killed after they have been inflicted with this type of poison have a 20% chance to drop Black Hearts.

TrinketsEdit

  Match Stick
  • Can replace the Tick.
  Missing Poster
  • No longer displays a particular puzzle piece on the last will screen if Isaac dies in a Sacrifice Room while holding it.
  • Dying in a Sacrifice Room while holding it unlock The Lost, regardless of the current character.
    • If The Lost was already unlocked, Isaac will be revived as The Lost and Missing Poster will be consumed.
    • If the player's character is already The Lost, he will be revived in the previous room and Missing Poster will be consumed.
  Mysterious Paper
  Tick

InteractionsEdit

*   20/20 +   Brimstone - Two brimstone shots are fired, without an increase in charge time.

PickupsEdit

BombsEdit

Troll Bomb
  • Troll Bombs are now given a random amount of time before exploding. Before that, they always exploded at a fixed time. This means that if two Troll Bombs spawn at the exact time right next to each other, there's a high chance one Troll Bomb will blow up before the other, sending that Troll Bomb sliding outwards a bit before exploding.

EntitiesEdit

MonstersEdit

Bony
  • Only leaves behind bones when killed.

EnvironmentEdit

RoomsEdit

Boss Room
  • Double Trouble boss rooms can now contain 2 bosses of different types. Additionally, they can appear as early as chapter 1.
Arcade

    

Angel Room
  • Possible rewards found in the room include:
  • Urns might spawn in the room.
  • Killing Key Key Master and Shell Game Beggar no longer applies the 25% bonus.
  • Donating to a Beggar until it pays out with an item on the current floor applies a 10% bonus instead of 25%.
  • Donating to a Devil Beggar until it pays out with an item on the current floor applies a 10% bonus instead of 25%.
    • If this coin flip succeeds, a Devil Room will be generated regardless of the above coin flips.
  • "You feel blessed!" fortune in the Sacrifice Room of the current floor applies a bonus:
    • If the "You feel blessed!" fortune appeared on the 3rd sacrifice, the chance will be 15%.
    • If the "You feel blessed!" fortune appeared on the 5th sacrifice, the chance will be 50%.
    • If both "You feel blessed!" fortunes appeared, the chance will be 65%.
  • Angel Rooms that spawn after Isaac defeats Mom's Heart or It Lives will be normal Angel Rooms with items or pickups.
  • A Troll Bomb can sometimes appear behind the Angel Statue, blowing it up. If the Angel fights have been unlocked, this will begin the boss fight if the player is not careful or quick enough to move the bomb.
Bedroom
  • The clean bedroom occasionally has two clean beds instead of one.
  • The trapdoor in a dirty bedroom has a chance to lead to a Crawl Space.
  • Occasionally, one Rag Man will spawn inside the dirty bedroom.
Boss Rush

    

  • If a sack spawns for whatever reason, picking it up will start the Boss Rush. The player can still pick up one of the pedestal items.
Black Market
  • Black Market can no longer be accessed in The Chest and The Dark Room, and therefore cannot be used to collect more items.
Curse Room
Challenge Room
  • The three waves appear in random orders rather than the original orders.
Sacrifice Room
  • The payouts only depend on the number of sacrifices made. The number of sacrifices is reset to 0 when the player goes to the next floor.
  • Rewards are reworked:
№ of sacrifices on Current Floor Chance Reward
1st/2nd 50% Nothing
50% 1 Penny
3rd 33% Nothing
67% "You feel blessed!" (increased chance to receive an Angel Room over a Devil Room for the current floor)
  • Does not increase the chance of a Devil/Angel room after defeating a boss, only the chance of getting an Angel Room over a Devil Room.
  • Can cause an Angel Room to spawn even if you already took a deal with the devil.
  • Less of a modifier than the "You feel blessed!" effect below.
4th 50% Nothing
50% 1 random chest (The type of chest is governed by the same mechanic as room drops. Thus, brown chests are more likely to spawn than any other kind of chest.)
5th 33% 3 Pennies (These coins do not have a chance to spawn as a nickel or a dime.)
67% You feel blessed!" (Same conditions as 3rd sacrifice but a stronger modifier.)
6th 33% Teleport to the Devil/Angel Room. (If the floor's Devil/Angel Room has not been entered yet, an Angel Room is guaranteed to spawn — even if you already took a Devil Deal.)
67% 1 random chest (The type of chest is governed by the same mechanic as room drops. Thus, brown chests are more likely to spawn than any other kind of chest.)
7th 33% 1 random Angel Room pedestal item.
67% 1 Soul Heart
8th 100% 6 Troll Bombs
9th 100% Uriel battle
10th 50% 7 Soul Hearts
50% 30 Pennies
11th 100% Gabriel battle
12th and onwards 50% Nothing
50% Teleport directly to the Dark Room
  • Losing red hearts due to the spikes will reduce the chance for a Devil Room to appear.
  • The amount of luck that the player has does not affect the payout probabilities.
  • Angels are normally able to fly over spikes, but will take damage from sacrifice room spikes.
  • New layouts:

    

Secret Room
Shop
  • There is a small chance when you bomb the Shopkeeper that they can turn into Greed and start attacking you.
Super Secret Room
Treasure Room
  • There's a rare chance that a treasure room might contains two items to choose from, only one of which can be taken.
  • Treasure rooms may also contain a Restock Machine, allowing Isaac to re-roll offered items if he has coins or bombs.
  • New layouts:

                           

OtherEdit

  • When not having red hearts in Devil Room, the price of items switches to soul hearts.
  • Krampus has a new attack pattern.
  • The floor icons on the stage transition sprites are updated; instead of being large rectangles with the unknown ones being grey, the sprites feature a much thinner and more detailed border with the unknown floors being represented by a closed trap door.

GalleryEdit

TriviaEdit