The Binding of Isaac: Afterbirth †

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Issues: Incomplete list of fixed bugs and new bugs.

Afterbirth † is an expansion to The Binding of Isaac: Afterbirth that was released on January 3, 2017 and costs $9.99.

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

Nicalis, the game's publisher, also created mod tools for easier creation of community mods with the release. They occasionally released updates to Afterbirth † that incorporated certain high-quality and popular mods. These updates are known as Booster Packs.

Features[edit | edit source]

Official description Complete description
  • PLUS DEV TOOLS! so you can design, edit and play and endless number of mods, features and whole new games that the community will no doubt eventually design..
  • 100s of new rooms! ( tons of new ultra rare rooms )
  • 1500+ new rooms! ( tons of new ultra rare rooms )
  • new victory lap feature! (allows the game to continue when finished)
  • Bestiary! (enemy collection page that keeps track of everything you kill in game)
  • Small monthly content updates! ( every month after release we will be updating the game with our favorite fan made designs, monsters, items maybe even challenges? who knows…)
  • 4+ new bosses and a new alt forms for existing bosses!
  • 4+ new bosses and a new alt forms for existing bosses!
  • New enemies, features and new champion forms!
  • 20 new enemies and 4 new champion forms!
  • New cut scenes and music tracks!
  • 2 new cut scenes and 4 music tracks!

Additions[edit | edit source]

Mechanics[edit | edit source]

HUD[edit | edit source]

Found HUD
  • Found HUD is a HUD addition that appears on the left side of the screen that gives numerical values to the player's current stats (e.g., damage, luck, speed, devil room chance). It can be enabled through the options menu.
  • It is based off of the Missing HUD mod for Rebirth and Afterbirth.

Victory Lap[edit | edit source]

  • A Victory Lap allows you to start a new run with almost all of your final items after completing the Dark Room. Multiple laps can be made as long as the Dark Room is cleared each time.
    • Completion Marks and most Achievements cannot be earned.
    • Isaac will take a full heart of damage on all floors after beginning a victory lap (unless he has The Wafer).
    • Some Items are lost upon starting a victory lap. Items lost this way are added back into their respective item pools and can be acquired again.
    • If the initial run was on normal difficulty, all victory laps will be on hard difficulty.
    • On the third and subsequent victory laps, the character will turn into The Lost. This version of The Lost does not get a Holy Mantle or D4. However, if the run was started as The Lost (or if the Holy Mantle was found) it is possible to keep the Holy Mantle from the previous run.
    • On the third and subsequent victory laps, shops will no longer appear.
    • On the third and subsequent victory laps, red chests in the Dark Room will turn into brown chests and golden chests.
    • Killing any final boss aside from The Lamb will end the game, and the run will not be continued further.

Menus[edit | edit source]

Options[edit | edit source]

Charge bars
  • Added a new "charge bars" option in the menu, for passive items that need to be charged up before usage.
  • This includes:
    • Brimstone Brimstone
      Brimstone Icon.pngTears are replaced by a laser beam that pierces through all enemies and obstacles in its path and deals high damage. Can only be fired after a short charge-up period.
      (collectible and Azazel)
    • Cambion Conception Cambion Conception
      Cambion Conception Icon.pngAfter taking damage a certain amount of times, a permanent demonic familiar spawns.
    • Chocolate Milk Chocolate Milk
      Chocolate Milk Icon.pngGrants charged tears that deal greater damage when fully charged.
    • Cursed Eye Cursed Eye
      Cursed Eye Icon.pngGrants charged tears that can be fired in a tight burst of four. Getting hit while charging will teleport Isaac into another room.
    • Lil Brimstone Lil Brimstone
      Lil Brimstone Icon.pngA Familiar that shoots a thin Brimstone beam. Must charge like Brimstone before shooting.
    • Lil Delirium Lil Delirium
      Lil Delirium Icon.pngGrants a familiar that transforms into another random familiar every 10 seconds.
    • Lil Gurdy Lil Gurdy
      Lil Gurdy Icon.pngGives 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 Monstro Lil Monstro
      Lil Monstro Icon.pngSpawns a familiar that fires clusters of tears. Must be charged before shooting.
    • Maw of the Void Maw of the Void
      Maw of the Void Icon.png+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.
    • Mom's Knife Mom's Knife
      Mom's Knife Icon.pngIsaac's tears are replaced by a knife that pierces enemies, can travel through obstacles, and can hurt enemies while Isaac is holding it. Holding down the fire button before firing increases its range and power.
    • Monstro's Lung Monstro's Lung
      Monstro's Lung Icon.pngIncreases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.
    • Tech X Tech X
      Tech X Icon.pngTears 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.
RERUN
  • RERUN is unlocked after completing the RERUN achievement.
  • After winning a run the Continue option in the main menu will be replaced by Rerun. Selecting it starts a new run using most of the previous won run's items. Isaac will take full heart damage on all floors.

Player[edit | edit source]

Characters[edit | edit source]

Character Apollyon App.png
Apollyon
The Forgotten App.png
The Forgotten
Health Stat Icon.png Health Red HeartRed Heart Bone HeartBone Heart
Soul Heart (soul)
Damage Stat Icon.png Damage 3.5 (*1.00) Forgotten: 3.50 (*1.50)
Soul: 3.50 (*1.00)
Tears Stat Icon.png Tears +0 +0
Shot Speed Stat Icon.png Shot Speed 1 1
Range Stat Icon.png Range 23.75 23.75
Speed Stat Icon.png Speed 1.0 Forgotten: 1.00
Soul: 1.30
Luck Stat Icon.png Luck 0 0
Starting Item Icon.png Starting Pickups None None
Starting Item Icon.png Starting Item(s) Void Void
Void Icon.png6 roomsConsumes all pedestal items in the room. Active items will have their effects added to Void, and passive items will grant stat upgrades.
None

Transformations[edit | edit source]

Name Appearance Description Items
Bookworm Bookworm
  • Roughly 50% of the time, Isaac shoots an extra tear, like 20/20.
Anarchist Cookbook Anarchist Cookbook
Anarchist Cookbook Icon.png3 roomsSpawns six troll bombs around the room.

The Bible The Bible
The Bible Icon.png6 roomsUpon activation, Isaac gains flight, allowing him to pass over all obstacles in the current room. Instantly kills Mom, Mom's Heart, and It Lives when activated, but will kill Isaac when activated while fighting Satan.

The Book of Belial The Book of Belial
The Book of Belial Icon.png3 roomsUpon use increases damage by 2 for the current room and by a further +50% if the character also has the Blood of the Martyr.
Removed in Afterbirth Guarantees a Devil Room or Angel Room will be open after beating a boss while holding it, or Added in Afterbirth increases the chance by 12.5%.

Book of Revelations Book of Revelations
Book of Revelations Icon.png6 roomsAdds 1 soul heart, increases the chance for a Devil or Angel Room to appear, and increases the chance for the next boss to be a Horseman (except on XL floors and floors with fixed bosses such as Mom).

Book of Secrets Book of Secrets
Book of Secrets Icon.png6 roomsUpon use, gives the effect of Treasure Map, The Compass, or Blue Map for the duration of the current floor.

Book of Shadows Book of Shadows
Book of Shadows Icon.png3 roomsUpon use, creates a protective shield nullifying all types of damage for 10 seconds.

The Book of Sin The Book of Sin
The Book of Sin Icon.png4 roomsSpawns a random pickup, pill, card, or trinket.

Book of the Dead Book of the Dead
Book of the Dead Icon.png4 roomsUpon use, spawns a charmed Bony or an orbital bone for each enemy killed in the current room.

How to Jump How to Jump
How to Jump Icon.pngUnlimitedGives Isaac the ability to jump (over gaps, spikes, etc.).

The Necronomicon The Necronomicon
The Necronomicon Icon.png6 roomsDamages all enemies in the room significantly.

Monster Manual Monster Manual
Monster Manual Icon.png3 roomsSummons a random familiar for the current room. Can summon familiars not yet unlocked.

Satanic Bible Satanic Bible
Satanic Bible Icon.png6 roomsUpon activation, Isaac gains a black heart.

Telepathy for Dummies Telepathy for Dummies
Telepathy for Dummies Icon.png2 roomsUpon activation, grants homing tears for the current room.

Spider Baby Spider Baby
  • Spawns a spider familiar that applies random status effects to enemies it comes in contact with.
Box of Spiders Box of Spiders
Box of Spiders Icon.png2 roomsSummons 2-4 blue spiders.

Spider Butt Spider Butt
Spider Butt Icon.png2 roomsDamages all enemies in the room and slows them and their projectiles down.

Mutant Spider Mutant Spider
Mutant Spider Icon.pngGrants quadruple shot but decreases tears.

Spider Baby Spider Baby
Spider Baby Icon.pngWhen hit, spawns up to 2 blue spiders.

Spider Bite Spider Bite
Spider Bite Icon.pngAdds a chance to shoot slowing tears, reducing speed of enemy movement and any projectile fired by them.

Spider Mod Spider Mod
Spider Mod Icon.pngDisplays 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.

Transformations
Guppy Beelzebub Added in Afterbirth  Super Bum Added in Afterbirth  Yes Mother? Added in Afterbirth  Bob Added in Afterbirth  Fun Guy Added in Afterbirth  Leviathan Added in Afterbirth  Conjoined
Added in Afterbirth  Spun Added in Afterbirth  Seraphim Added in Afterbirth  Oh Crap Added in Afterbirth †  Bookworm Added in Afterbirth †  Spider Baby Added in Afterbirth †  Adult Added in Afterbirth †  Stompy


Upon taking three Puberty pills, Isaac will turn into an adult and gain a heart container. Isaac's voice will also become deeper.

Consuming a further three Puberty pills has no effect.

Trivia[edit | edit source]

  • This transformation and Stompy are the only transformations that pills count towards.


The Binding of Isaac: Rebirth The Binding of Isaac: Rebirth The Binding of Isaac: Rebirth
MainPageAchievements.png Achievements MainPageAttributes.png Attributes MainPageBosses.png Bosses TarotCard.png Cards and Runes MainPageChallenges.png Challenges MainPageChapters.png Chapters
Isaac App.png Characters MainPageBabies.png Co-op MainPageItems Small.png Items Item Pools Item Pools MainPageMonsters.png Monsters MainPageObjects.png Objects
Red heart.png Pickups BlueBlue.png Pills MainPageRooms.png Rooms MainPageSeeds2.png Seeds Guppy App.png Transformations The Left Hand Icon.png Trinkets
Stompy None
  • Taking damage has a chance to spawn rock waves.
Leo Leo
Leo Icon.pngAllows you to crush rocks when you walk over them.

Magic Mushroom Magic Mushroom
Magic Mushroom Icon.pngIncreases all stats and enlargens Isaac.

One Makes You Larger pill

Co-op[edit | edit source]

Special Babies

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

ID Appearance Name Description
55 055 baby mort.png Mort Baby Spawns a blue fly, and spawns a new blue fly whenever its blue fly is destroyed.
Mort Baby Defeat Mega Satan as Apollyon
Mort BabyMort Baby
to unlock it. The sprite greatly resembles Rotten Baby Rotten Baby
Rotten Baby Icon.pngA familiar that spawns blue flies.
.
56 056 baby apollyon.png Apollyon Baby Spawns with two Pretty Flies.
Apollyon Baby Earn all Hard Mode Completion Marks as Apollyon
Apollyon BabyApollyon Baby
to unlock it.
57 057 baby boner.png Bone Baby Wields a melee bone club instead of shooting tears, similarly to The Forgotten.
Bone Baby Earn all Hard Mode Completion Marks as The Forgotten
Bone BabyBone Baby
to unlock it.
58 058 baby bound.png Bound Baby Is bound to Isaac, similarly to The Forgotten's soul. Shoots spectral tears.
Bound Baby Defeat Mega Satan as The Forgotten
Bound BabyBound Baby
to unlock it.

Normal Babies

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

ID Appearance Name Description
428 428 baby magiccat.png Magiccat Baby A baby that resembles the avatar of Tikara, the artist of the Isaac Tarot deck.
429 429 baby littlehorn.png Little Horn Baby A baby that resembles Little Horn.
430 430 baby folder.png Folder Baby A baby with a folder for a head.
431 431 baby driver.png Driver Baby A baby that is driving a car.
432 432 baby dragon.png Dragon Baby A baby that resembles a dragon.
433 433 baby downwell.png Downwell Baby A baby that resembles the player character from Downwell.
434 434 baby cylinder.png Cylinder Baby A baby that is shaped like a cylinder.
435 435 baby cup.png Cup Baby A baby with a teacup for a head.
436 436 baby cave robot.png Cave Robot Baby A baby that resembles Quote from Cave Story.
437 437 baby breadmeat hoodiebread.png Breadmeat Hoodiebread Baby A toothy baby with a slice of toast for a head that resembles Breadmeat, a member of the Isaac community.
438 438 baby bigmouth.png Bigmouth Baby A baby with a large, wide-open mouth.
439 439 baby afro rainbow.png Afro Rainbow Baby A baby with a rainbow colored afro.
440 440 baby afro.png Afro Baby A baby with an afro.
441 441 baby tv.png TV Baby A baby with a television for a head.
442 442 baby tooth.png Tooth Baby A baby with a tooth for a head.
443 443 baby tired.png Tired Baby A tired-looking baby.
444 444 baby steroids.png Steroids Baby A muscular baby.
445 445 baby soap monster.png Soap Monster Baby A baby that resembles Balrog from Cave Story.
446 446 baby rojen whitefox.png Rojen Whitefox Baby A baby that resembles a white fox. (might be a reference?)
447 447 baby rocket.png Rocket Baby A baby that looks like a firework.
448 448 baby nurf.png Nurf Baby A baby that resembles D.Va from Overwatch.
449 449 baby mutated fish.png Mutated Fish Baby A baby that resembles Fish from Nuclear Throne.
450 450 baby moth.png Moth Baby A baby that resembles Moth from Creepy Castle.
451 451 baby buttface.png Buttface Baby A baby with a butt for a face.
452 452 baby flying candle.png Flying Candle Baby A baby that looks like a candle.
453 453 baby graven.png Graven Baby A baby with long hair. (might be a reference?)
454 454 baby gizzy chargeshot.png Gizzy Chargeshot Baby A baby that resembles Gizzy from ChargeShot.
455 455 baby green koopa.png Green Koopa Baby A baby that resembles a green koopa from Mario.
456 456 baby handsome mrfrog.png Handsome MrFrog Baby A baby that resembles Handsome Mr. Frog from the game of the same name.
457 457 baby pumpkin guy.png Pumpkin Guy Baby A baby with a pumpkin for a head wearing a purple rag. Possible reference to Terraria's Pumpking.
458 458 baby red koopa.png Red Koopa Baby A baby that resembles a red koopa from Mario.
459 459 baby sad bunny.png Sad Bunny Baby A baby that looks like a crying rabbit. This is a reference to the sprites creator, Mort Mort (MnrArt) and their character Sad Bunny Face.
460 460 baby saturn.png Saturn Baby A baby that resembles the main character from Sgt. Saturn.
461 461 baby toast boy.png Toast Boy Baby A baby with a slice of bread for a head. This is a reference to the sprite's creator, Mort Mort (MnrArt) and their character Toast Boy.
462 462 baby voxdog.png Voxdog Baby A baby that looks like a happy dog. (might be a reference?)
463 463 baby 404.png 404 Baby A baby that has the Error trinket for a head.
464 464 baby arrowhead.png Arrowhead Baby A baby with an arrow through its head.
465 465 baby beanie.png Beanie Baby A baby wearing a green beanie.
466 466 baby blindcursed.png Blindcursed Baby A baby with the Curse of the Blind's question mark for a head.
467 467 baby burning.png Burning Baby A baby that's been burnt to a crisp.
468 468 baby cursor.png Cursor Baby A baby that looks like a mouse cursor.
469 469 baby flybaby.png Flybaby A baby that looks like a fly.
470 470 baby headphone.png Headphone Baby A baby wearing headphones.
471 471 baby knife.png Knife Baby A baby with a knife for a head.
472 472 baby mufflerscarf.png Mufflerscarf Baby A baby wearing a scarf.
473 473 baby robbermask.png Robbermask Baby A baby wearing a stereotypical robber's ski mask.
474 474 baby scoreboard.png Scoreboard Baby A baby with a digital number display, like those at a sporting event or on an alarm clock, for a face.
475 475 baby somanyeyes.png So Many Eyes Baby A baby with eyes all over its body.
476 476 baby text.png Text Baby A baby made out of text characters. (ASCII art)
477 477 baby wing.png Wing Baby A baby with wings.
480 480 baby imp.png Imp Baby A baby that resembles the modded character Fiend from Devil's Harvest.
481 481 baby 32bit.png 32bit Baby A baby that resembles Isaac in a 32 bit style.
482 482 baby adventure.png Adventure Baby A baby that resembles Finn the Human from Adventure Time.
483 483 baby bubbles.png Bubbles Baby A baby made entirely of tar.
484 484 baby bulb.png Bulb Baby A baby that's very bright for his age.
485 485 baby coolorange.png Cool Orange Baby A baby that resembles a very cool orange with sunglasses.
486 486 baby crazyghost.png Crazy Ghost Baby A baby that resembles Crazy Diamond from JoJo's Bizarre Adventure. (Also possibly a reference to the modded character.)
487 487 baby cursedpillow.png Cursed Pillow Baby A baby that's unfortunately pillow shaded.
488 488 baby egg.png Egg Baby A baby that resembles the modded item Greg the Egg.
489 489 baby factory.png Factory Baby A baby that resembles a strange cyborg.
490 490 baby falling.png Falling Baby A baby that resembles a white pineapple with goggles.
491 491 baby funny.png Funny Baby A baby that resembles Sans from Undertale.
492 492 baby gamer.png Gamer Baby A baby that resembles an epic gamer. Inspired by a prominent member of the Binding of Isaac community.
493 493 baby glitterypeach.png Glittery Peach Baby A baby resembling an oddly British Baby Plum from Antibirth.
494 494 baby pompadour.png Pompadour Baby A baby that resembles Josuke from JoJo's Bizarre Adventure. (Also possibly a reference to the modded character.)
495 495 baby headkick.png Head Kick Baby A baby that resembles the Facepunch Logo.
496 496 baby horn.png Horn Baby A baby that resembles the modded character Chronos.
497 497 baby ichor.png Ichor Baby A baby that resembles Ichor beasts from the game Heckland.
498 498 baby ill.png Ill Baby A baby that resembles the modded boss Mahalath.
499 499 baby lazy.png Lazy Baby A baby that resembles Garfield.
500 500 baby mern.png Mern Baby Mern.
501 501 baby necro.png Necro Baby A baby that resembles the Xenomorph from the Alien franchise.
502 502 baby peeping.png Peeping Baby A baby that resembles the modded boss The Peeping.
503 503 baby penance.png Penance Baby A baby that resembles the modded character Sarah from Revelations.
504 504 baby psychic.png Psychic Baby A baby that resembles the modded character Mei.
505 505 baby puppet.png Puppet Baby A baby that resembles the costume for the modded item Pinhead from Happy Items Pack.
506 506 baby reaper.png Reaper Baby A baby that resembles the modded character Samael.
507 507 baby roadkill.png Road Kill Baby A baby that got ran over.
508 508 baby sausagelover.png Sausage Lover Baby A baby that resembles _Kilburn, the lead developer for Antibirth.
509 509 baby scribble.png Scribble Baby A baby that resembles the modded character The Drawn.
510 510 baby starplant.png Star Plant Baby A baby that resembles the main character from Germination. Or the Commando from Risk of Rain.
511 511 baby twitchy.png Twitchy Baby A baby that resembles Twitch from Heckland.
512 512 baby witch.png Witch Baby A baby that resembles the modded character Endor from Alphabirth.
513 513 baby workshop.png Workshop Baby A baby that references a common trope of workshop thumbnails when firing tears.
514 514 baby hooligan.png Hooligan Baby A baby that resembles Čeda from LeatherIceCream's "Poor 4" animations.
515 515 baby halfspider.png Half Spider Baby A baby that resembles Miroslav from LeatherIceCream's "Poor 4" animations.
516 516 baby silly.png Silly Baby A baby that resembles Djole from LeatherIceCream's "Poor 4" animations.
517 517 baby mastercook.png Master Cook Baby A baby that resembles Andre from LeatherIceCream's "Poor 4" animations.
518 518 baby greenpepper.png Green Pepper Baby A baby that resembles one of _Kilburn's characters.
519 519 baby baggycap.png Baggy Cap Baby A baby that resembles one of _Kilburn's characters.
520 520 baby stylish.png Stylish Baby A baby resembling the character Ren from the currently unreleased game Shenanigans: World of Illusions.

Items[edit | edit source]

109 new items were added in the expansion: 29 activated items and 80 passive items.

Activated Collectibles[edit | edit source]

Name ID Icon Quote Description
Black Hole 512
Black Hole
4 rooms
Nothing can escape Throws a black hole on the ground which sucks in and damages enemies.
Book of the Dead 545
Book of the Dead
4 rooms
Rise from the grave Upon use, spawns a charmed Bony or an orbital bone for each enemy killed in the current room.
Broken Shovel 550
Broken Shovel
4 rooms
It feels cursed While held, causes multiple Mom's Foots to come down and stomp on Isaac. One of two parts necessary to create Mom's Shovel.
Brown Nugget 504
Brown Nugget
7 seconds
Friendly fly Spawns a stationary fly familiar that fires tears at nearby enemies.
Clicker 482
Clicker
6 rooms
Change Transforms Isaac into another random character.
Compost 480
Compost
2 rooms
Gain more friends! Spawns a blue spider or fly. Turns pickups in the room into blue spiders or flies.
Coupon 521
Coupon
6 rooms
Allow 6 weeks for delivery Upon use, makes a random item from a shop, devil deal, or black market free.
Crooked Penny 485
Crooked Penny
4 rooms
50/50 Spawns a penny and has a 50% chance to double all items and pickups in the room. If the effect fails, the items and pickups disappear.
D1 476
D1
4 rooms
What will it be? Duplicates a random pickup in the room.
D Infinity 489
D Infinity
2 rooms
Reroll forever Grants a random dice item that changes each use.
Dataminer 481
Dataminer
4 rooms
109 Displaces enemy sprites for the current room and increases or decreases a random stat.
Delirious 510
Delirious
12 rooms
Unleash the power! Spawns a random charmed boss.
Dull Razor 486
Dull Razor
2 rooms
I feel numb... Hurts Isaac without depleting health, activating any items that trigger upon taking damage.
Eden's Soul 490
Eden's Soul
One time use
... Spawns two item pedestals.
Mama Mega! 483
Mama Mega!
One time use
BOOOOOOOOOM! Damages all enemies and destroys all obstacles. The effect occurs every time a new room is entered for the rest of the floor. Opens doors to the floor's secret and super secret rooms.
Metronome 488
Metronome
2 rooms
Waggles a finger Grants a random item effect for the current room.
Mom's Shovel 552
Mom's Shovel
4 rooms
Lost but not forgotten Spawns a trapdoor that leads to the next floor upon activation. Unlocks The Forgotten when used on a mound of dirt that appears in The Dark Room.
Moving Box 523
Moving Box
4 rooms
Pack and unpack If the box is empty, picks up all items and pickups in a room and stores them. If the box is not empty, places all stored items and pickups in the current room.
Mr. ME! 527
Mr. ME!
4 rooms
Caaan do! Summons a controllable ghost that can perform various tasks depending on what it targets.
Mystery Gift 515
Mystery Gift
One time use
Wrapped up nice for you! Upon use, spawns a random item from the current room's item pool, with a chance to spawn A Lump of Coal or The Poop instead.
Plan C 475
Plan C
One time use
Use with caution Kills all enemies in the room, then kills Isaac three seconds later.
Potato Peeler 487
Potato Peeler
Unlimited
A pound of flesh Removes a heart container, increases damage and range, and grants a Cube of Meat.
Pause 478
Pause
2 rooms
Stop! Freezes all enemies until a fire button is pressed.
Sacrificial Altar 536
Sacrificial Altar
One time use
He demands a sacrifice Upon use, sacrifices up to 2 familiars and spawns an item from the Devil Room Pool for each familiar sacrificed.
Sharp Straw 507
Sharp Straw
8 seconds
More blood! Damages all enemies in the room.
Smelter 479
Smelter
6 rooms
Trinket melter! Consumes Isaac's currently held trinket and applies its effect permanently.
Sprinkler 516
Sprinkler
4 rooms
Sprinkles. Upon use, spawns a sprinkler that rotates and fires tears.
Telekinesis 522
Telekinesis
3 seconds
Power of the mind Upon use, for the next two seconds, any enemy shots that come near Isaac are held in place. After the charge is depleted, they are fired back as tears.
Void 477
Void
6 rooms
Consume Consumes all pedestal items in the room. Active items will have their effects added to Void, and passive items will grant stat upgrades.
Wait What? 484
Wait What?
10 seconds
I can't believe it's not Butter Bean! Isaac farts, sending out rock waves.

Passive Collectibles[edit | edit source]

Name ID Icon Quote Description
7 Seals 526 7 Seals Lil harbingers! Grants a random Harbinger familiar that changes every 10 seconds.
Acid Baby 491 Acid Baby Pills pills pills! Spawns a familiar that drops random pills every 2 rooms cleared. Upon using a pill, all enemies in the room are poisoned.
Adrenaline 493 Adrenaline Panic = power Increases damage based on how many empty heart containers Isaac has.
Analog Stick 465 Analog Stick 360 tears! +0.3 tears up. Allows Isaac to fire tears diagonally.
Angelic Prism 528 Angelic Prism Eclipsed by the moon Grants a prism orbital with a large orbital radius. Tears that pass through the prism split into four multi-colored tears.
Angry Fly 511 Angry Fly He's violent Spawns a fly familiar that orbits around a random enemy and deals 5 damage per tick to enemies it comes in contact with.
Apple! 443 Apple! Trick or treat? Increases tears. Adds a chance to fire a high-damage razor blade.
Backstabber 506 Backstabber Watch your back! Has a chance to fire tears that inflict bleeding on enemies, causing them to slowly take damage over time.
Belly Button 458 Belly Button What's in there? Drops a random trinket. Grants a second trinket slot.
Big Chubby 473 Big Chubby Chub chub Spawns a familiar that slowly charges forward and damages enemies in its path.
Blanket 535 Blanket You feel Safe Grants one soul heart. Upon entering a boss room, grants a shield that blocks one hit, then disappears.
Bloodshot Eye 509 Bloodshot Eye Bloody friend Spawns an orbiting eye familiar that fires tears every 2 seconds.
Bozo 513 Bozo Party time! Increases damage by a flat 0.1 and grants a soul heart. Enemies can randomly become briefly charmed or feared. Taking damage has a chance to spawn a rainbow poop.
Brittle Bones 549 Brittle Bones Everything hurts Replaces all red hearts with 6 empty bone hearts. Upon losing a bone heart, Isaac fires bones in 8 directions and permanently gains a tears up.
Broken Modem 514 Broken Modem Lag! Enemies, enemy shots, tears, and pickups will briefly freeze in place at random intervals.
Broken Shovel 551 Broken Shovel It feels cursed One of two parts necessary to create Mom's Shovel.
Buddy in a Box 518 Buddy in a Box What could it be?! Grants a familiar with a random tear effect. The familiar is randomized at the start of each floor.
Camo Undies 497 Camo Undies Camo kid Isaac becomes camouflaged at the beginning of each room. Enemies will not attack Isaac until he starts firing tears.
Compound Fracture 453 Compound Fracture Bone tears! Increases range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle.
Cone Head 457 Cone Head Hard headed! Grants a soul heart. Adds a chance to block enemy shots.
Contagion 466 Contagion Outbreak! The first enemy killed in a room explodes and poisons nearby enemies. Poisoned enemies will also explode upon death.
Dad's Lost Coin 455 Dad's Lost Coin I remember this... Increases range by 1.5. Drops a lucky penny.
Dad's Ring 546 Dad's Ring Father's blessing Creates a ring of light around Isaac that petrifies enemies in contact.
Dark Prince's Crown 442 Dark Prince's Crown Loss is power Increases range, tears, and shot speed when at exactly one red heart.
Dead Tooth 446 Dead Tooth Halitosis While firing, Isaac gains a green aura that poisons nearby enemies.
Death's List 530 Death's List Just hope you're not next... Grants a reward if all enemies in a room are killed in the order they are marked.
Depression 469 Depression :( Spawns a cloud familiar that leaves a trail of tears that damages enemies. Has a chance to spawn damaging beams of light onto enemies that touch the cloud.
Divorce Papers 547 Divorce Papers Tears up + you feel empty Spawns a Mysterious Paper, increases tears, and grants a bone heart.
Dog Tooth 445 Dog Tooth Bark at the moon! Increases damage and speed. Upon entering a room adjacent to a secret room, a howl sound effect will play.
Duality 498 Duality You feel very balanced Whenever a Devil or Angel Room would spawn after defeating a boss, both rooms spawn. Only one can be entered.
Eucharist 499 Eucharist Peace be with you An Angel Room door will always spawn after every boss fight, excluding the first floor and floors after Utero II/Womb II.
Euthanasia 496 Euthanasia Needle shot Adds a chance to fire needles. If a needle kills an enemy, it bursts into more needles.
Eye of Belial 462 Eye of Belial Possessed tears! Grants piercing tears. After piercing one enemy, tears start homing and deal double damage.
Eye of Greed 450 Eye of Greed Gold tears! Adds a chance to fire tears that temporarily stun enemies and turn them into gold. Any enemy killed while in this state will drop coins.
Fast Bombs 517 Fast Bombs Rapid bomb drops Grants 7 bombs and allows bombs to be placed rapidly.
Finger! 467 Finger! Watch where you point that! Spawns a finger familiar that points at enemies, dealing constant damage.
Flat Stone 540 Flat Stone Skipping tears Tears bounce off the floor. Tears that hit an enemy after bouncing deal splash damage to all nearby enemies for 25% of Isaac's tear damage.
Ghost Pepper 495 Ghost Pepper Flame tears Adds a chance to shoot a fire that damages enemies and remains in place until it deals enough damage or the room is left.
Glaucoma 460 Glaucoma Blind tears! Adds a chance to shoot concussive tears, causing enemies to walk around randomly.
Glyph of Balance 464 Glyph of Balance A gift from above Grants 2 soul hearts and modifies drops from Champion Monsters based on certain conditions.
Greed's Gullet 501 Greed's Gullet Money = health! Grants a heart container for every 25 coins Isaac has.
Haemolacria 531 Haemolacria I'm seeing red... Tears are now fired in an arc. Upon hitting the floor, an obstacle, or an enemy, they burst into many smaller tears in all directions. Increases tear delay.
Hallowed Ground 543 Hallowed Ground Portable sanctuary Spawns a white poop familiar, which turns into a white poop when Isaac is hurt.
Hushy 470 Hushy Lil hush! Spawns a Hush familiar that bounces around the room and deals contact damage. While firing tears, it stops moving.
Jacob's Ladder 494 Jacob's Ladder Electric tears Tears fire sparks of electricity in random directions upon hitting an obstacle or enemy.
Jaw Bone 548 Jaw Bone Fetch! Spawns a familiar that flies the room while firing, dealing double Isaac's tear damage to enemies that come in contact and retrieving pickups.
Jumper Cables 520 Jumper Cables Bloody recharge Grants an active item charge every 15 enemies killed.
King Baby 472 King Baby Lord of the dead! Spawns a familiar that follows Isaac and makes other familiars follow it. While firing tears, it stops moving.
Lachryphagy 532 Lachryphagy Feed them! Isaac's tears decelerate as they travel. Upon stopping or hitting an obstacle, they burst into 8 tears in all directions. Tears can be fired into other tears to feed them, increasing their damage.
Large Zit 502 Large Zit Creep shots Adds a chance to fire a creep shot that deals double damage and leaves a trail of slowing white creep.
Lead Pencil 444 Lead Pencil He's a bleeder! After every 15 tears fired, Isaac will fire a high-damage cluster of tears.
Leprosy 525 Leprosy You're tearing me apart! Upon taking damage, grants a body part as an orbital, which blocks enemy shots and deals 7 damage per tick to enemies it comes in contact with. The orbitals will be destroyed if they take enough damage from enemies or enemy shots.
Lil Delirium 519 Lil Delirium Delirious friend Grants a familiar that transforms into another random familiar every 10 seconds.
Lil Monstro 471 Lil Monstro Ain't he cute? Spawns a familiar that fires clusters of tears. Must be charged before shooting.
Lil Spewer 537 Lil Spewer Puking buddy Spawns a random pill, and grants a small Spewer familiar that charges up and fires different types of creep.
Linger Bean 447 Linger Bean Crying makes me toot Adds a chance to fire a gas cloud that damages nearby enemies.
Little Horn 503 Little Horn Science! Adds a chance to fire a piercing tear that instantly kills any enemy that it touches.
Marbles 538 Marbles Choking hazard Spawns 3 random trinkets. Taking damage has a small chance to swallow Isaac's currently held trinket, gaining its effect permanently.
Marrow 541 Marrow HP up? Grants one bone heart and spawns three red heart pickups.
Metal Plate 449 Metal Plate It itches... Adds a chance to reflect enemy shots. Grants one soul heart.
Moldy Bread 456 Moldy Bread Midnight snack! Grants one full red heart container.
Mom's Razor 508 Mom's Razor It's sharp! Spawns an orbiting razor that damages enemies it touches and inflicts bleeding on enemies, causing them to slowly take damage over time.
Mystery Egg 539 Mystery Egg Sacrificial insemination Spawns an egg familiar, which cracks and turns into a random charmed enemy when Isaac is hurt. The egg regenerates upon entering a different room.
Parasitoid 461 Parasitoid Egg tears! Adds a chance to fire an egg sack which spawns slowing creep and spawns a blue fly or spider upon hitting an enemy.
Pointy Rib 544 Pointy Rib Stabbing time Spawns a bone familiar that can be aimed with the fire buttons and does contact damage.
Poke Go 505 Poke Go Gotta catch em... Upon entering a room with enemies in it, has a chance to spawn a random charmed enemy that persists across rooms.
Polydactyly 454 Polydactyly Hold me! Allows Isaac to carry two cards, pills, or any combination of both at the same time. Drops a random card or pill.
Pop! 529 Pop! Eyeball tears! Replaces Isaac's tears with eyeballs that can bounce off of each other. The eyeballs are not limited by range, and will instead dissipate when they stop moving or when hitting an enemy or obstacle.
Sack of Sacks 500 Sack of Sacks Gives sacks Spawns a sack familiar that has a chance to drop a sack upon clearing a room.
Schoolbag 534 Schoolbag Extra active item room Allows Isaac to hold two active items.
Shade 468 Shade It follows Spawns a shadow familiar that follows Isaac's movements on a 1 second delay and deals contact damage to enemies.
Shard of Glass 448 Shard of Glass Blood and guts! Upon taking damage, Isaac has a chance to drop a full red heart, gain 5 range, and leave a trail of damaging red creep for the current room.
Sinus Infection 459 Sinus Infection Booger tears! Adds a chance to fire a booger which sticks to enemies and poisons them.
Slipped Rib 542 Slipped Rib Projectile shield Spawns a bone familiar that circles around Isaac and reflects enemy shots.
Sulfuric Acid 463 Sulfuric Acid Acid tears! Increases damage. Adds a chance to fire acidic tears which can destroy obstacles.
Tarot Cloth 451 Tarot Cloth I see the future Drops a random card or rune. Doubles the effects of cards and runes.
Technology Zero 524 Technology Zero Static tears! Connects Isaac's tears with electricity that can damage enemies.
Trisagion 533 Trisagion Smite thy enemy Tears are replaced with piercing white blasts of light.
Varicose Veins 452 Varicose Veins I'm leaking... Taking damage releases a ring of 10 high damage tears.
YO LISTEN! 492 YO LISTEN! Yo listen! +1 luck. Spawns a fairy familiar that points out secret room entrances and tinted rocks.

Trinkets[edit | edit source]

38 new trinkets were added in the expansion.

Name ID Icon Quote Description
Baby-Bender 127 Baby-Bender Feed them magic! Grants Isaac's familiars homing shots.
Bag Lunch 105 Bag Lunch I wonder what it is Taking damage has a small chance to destroy the trinket and spawn Lunch.
Bat Wing 118 Bat Wing They are growing... Upon killing an enemy, has a chance to grant flight for the rest of the room.
Black Tooth 95 Black Tooth It looks dead Adds a chance to fire a black tooth that poisons enemies.
Bloody Crown 111 Bloody Crown Drips with blood... Treasure Rooms appear in Chapter 4.
Butter! 122 Butter! Can't hold it! Using an active item will drop it onto a pedestal on the ground. Taking damage may result in dropping a passive item.
Crow Heart 107 Crow Heart Drain me Red heart damage will be taken before soul and black heart damage.
Cracked Crown 92 Cracked Crown Stat booster Grants extra stat upgrades based on Isaac's passive items that increase stats, +0.2 tears, -1 tear delay.
Dim Bulb 101 Dim Bulb I think it's broken Provides a boost to all stats when Isaac's active item is completely uncharged.
Door Stop 124 Door Stop Hold the door! The last door Isaac went through stays open, allowing him to leave the room even if enemies are in it.
Duct Tape 109 Duct Tape Stuck! Stops Isaac's familiars from moving.
Equality! 103 Equality! = Turns pickups into their doubled versions while Isaac's numbers of coins, bombs, and keys are equal.
Extension Cord 125 Extension Cord Charged friends Beams of yellow electricity flow between Isaac and his familiars, damaging any enemies between them.
Filigree Feather 123 Filigree Feather Angelic Spoils! Angels drop items instead of key pieces when defeated.
Finger Bone 128 Finger Bone It looks brittle Grants a chance to gain a bone heart upon taking damage.
Fish Tail 94 Fish Tail It also stinks! Items and trinkets that generate blue flies or blue spiders will generate twice as many.
Fragmented Card 102 Fragmented Card Double moon Makes two Secret Rooms spawn on each floor.
Hairpin 120 Hairpin Danger charge Fully recharges Isaac's active item upon entering a boss fight.
Locust of Conquest 117 Locust of Conquest I bring Conquest Upon entering a room with enemies, spawns 2-5 White Locusts which damage enemies.
Locust of Death 116 Locust of Death I bring Death Upon entering a room with enemies, spawns a Black Locust that does a very high amount of damage.
Locust of Famine 115 Locust of Famine I bring Famine Upon entering a room with enemies, spawns a Yellow Locust that damages and slows enemies.
Locust of Pestilence 114 Locust of Pestilence I bring Pestilence Upon entering a room with enemies, spawns a Green Locust which damages and poisons enemies.
Lost Cork 106 Lost Cork Uncorked Increases the radius of any creep produced by Isaac.
Nose Goblin 98 Nose Goblin Seems magic... Chance to fire a booger that sticks to enemies and deals damage over time.
Ouroboros Worm 96 Ouroboros Worm Foop foop! Tears travel in a large spiral pattern and become spectral.
Pay to Win 112 Pay to Win ... Restock boxes always spawn in Item Rooms.
Rotten Penny 126 Rotten Penny Wealth of flies Spawns a blue fly every time a coin is picked up.
Silver Dollar 110 Silver Dollar Feels lucky... Shops appear in Chapter 4.
Stem Cell 119 Stem Cell Regen! Heals for half a heart upon traveling to the next floor.
Super Ball 99 Super Ball Boing! Makes tears have a chance to bounce off enemies and obstacles.
Tonsil 97 Tonsil Sick... When hit, there is a small chance a removed tonsil familiar starts following Isaac, blocking enemy shots.
Used Diaper 93 Used Diaper You stink Grants the Skatole effect in some rooms.
Vibrant Bulb 100 Vibrant Bulb It needs power Provides a boost to all stats when Isaac's active item is fully charged.
Walnut 108 Walnut That's a hard nut to crack! Taking damage has a small chance to destroy the trinket and spawn various pickups.
Wish Bone 104 Wish Bone Make a wish Taking damage has a small chance to destroy the trinket and spawn a random item.
Wooden Cross 121 Wooden Cross My faith protects me Grants a Holy Mantle shield upon entering a new floor, which protects against one hit of damage.

Pickups[edit | edit source]

Hearts[edit | edit source]

Heart Image Worth Additional Info
Scared Heart Red heart.png Red Heart Identical to the standard Red Heart, but will run away as the player moves towards it.
Half Soul Heart Half soul heart.png Half Soul Heart
Blended Heart Red soul heart.png Red Heart/Soul Heart/Half Red HeartHalf Soul Heart Fills up a full red Heart Container, but will act as a Soul Heart when no Containers are free. If you are only missing half a heart, it will fill that half, and give you half a soul heart.
Bone Heart Bone heart.png Empty Bone Heart Takes three hits to deplete and can be refilled with red hearts, but disappears permanently upon depleting.

Keys[edit | edit source]

Key Image Worth Additional Info
Charged Key ChargedKey.gif 1

Fully charges your currently held active item upon pickup. Can be differentiated from regular keys by having a pulsating white glow while on the ground.

Pills[edit | edit source]

ID Pill Effect
39 X-Lax

Creates a pool of slippery brown creep underneath Isaac.

40 Something's wrong...

Creates a pool of black creep beneath Isaac.

41 I'm Drowsy...

Upon use, slows all enemies for the duration of the room.

42 I'm Excited!!!

Upon use, increases the speed of all enemies for the duration of the room. The effect triggers again 30 seconds after use and 60 seconds after use.

43 Needs to be unlocked Gulp!

Upon use, any trinkets that the player is holding are destroyed, and their effects are permanently applied to the player.
Unlocked by acquiring the Once More With Feeling! achievement.

44 Needs to be unlocked Horf!

Upon use, Isaac shoots an explosive tear with the Ipecac Ipecac

Ipecac Icon.pngReplaces tears with explosive and poisoning projectiles fired in an arc from the mouth.
effect that always deals 200 damage.
Unlocked by acquiring the Dedication achievement.

45 Needs to be unlocked Feels like I'm walking on sunshine!

Temporarily makes Isaac invincible, similar to Unicorn Stump Unicorn Stump

Unicorn Stump Icon.png1 roomsUpon use, grants invulnerability and increased speed for five seconds, but removes the ability to shoot tears.
.
Unlocked by acquiring the Sin Collector achievement.

46 Needs to be unlocked Vurp!

Throws up the last pill you used. Will spawn itself if no other pills were taken beforehand.
Unlocked by acquiring the U Broke It! achievement.

Cards[edit | edit source]

Name ID Icon Message Effect
Ace of Clubs 27 Ace of Clubs Icon.png Convert all Turns all pickups and chests in the room into bombs.
Ace of Diamonds 28 Ace of Diamonds Icon.png Convert all Turns all pickups and chests in the room into coins.
Ace of Hearts 30 Ace of Hearts Icon.png Convert all Turns all pickups and chests in the room into random heart pickups.
Ancient Recall 53 Ancient Recall Icon.png Draw 3 cards Spawns 3 random cards.
Era Walk 54 Era Walk Icon.png Savor the moment For the current room, enemies are slowed, Isaac's speed is increased, and his shot speed is decreased.
Holy Card 51 Holy Card Icon.png You feel protected Grants the Holy Mantle effect for the current room.
Huge Growth 52 Huge Growth Icon.png Become immense! Makes Isaac large for the current room, increasing his range and damage.

Runes[edit | edit source]

Rune ID Icon Unlock method Message Effect
Black Rune 41 Black Rune Icon.png Black Rune Defeat Ultra Greedier as Apollyon
Black RuneBlack Rune
Void Deals 40 damage to all enemies in the room. Consumes all pickups in the room and turns them into blue flies and spiders. Consumes all pedestal items in the room and turns them into random stat upgrades.

Chests[edit | edit source]

Mimic Chest.png Mimics
  • Mimics appear similar to Brown Chests until Isaac moves near, at which point they sprout spikes that damage the player as a Spike Chest would. They can be distinguished from Brown Chests by their darker, purplish-brown coloring, the grayish spot on each side of the latch where the spikes will sprout from and the bloodstain.

Entities[edit | edit source]

Monsters[edit | edit source]

Monster Description
Blister
Blister
Slowly hops towards Isaac, occasionally spawning black smoke balls. Spawns a Sack upon death.
Crispy
Crispy
Slowly walks towards Isaac, but increases in speed as they take damage. Constantly passively takes damage.
Cross Grimace
Cross Grimace
Stationary and invulnerable monster that continuously fires shots in four directions.
Cross Stoney
Cross Stoney
Chases Isaac and shoots 4 tears vertically and diagonally like a Cross Grimace. Dies when the room is cleared.
Dank Charger
Dank Charger
Slowly moves around the room, charging at Isaac very rapidly when he gets in its line of sight, leaving a trail of slowing black creep.
Fistuloid
Fistuloid
Flies towards Isaac in an erratic waving motion, periodically firing a blood shot towards Isaac that also knocks itself back. Upon death, fires a worm that flies off screen.
Gush
Gush
Stationary, harmless enemy that continually creates slowing black creep.
Leper
Leper
Walks around the room, avoiding Isaac. Releases a Leper Flesh for every 15 damage taken. After being reduced to 15 health, starts chasing Isaac and leaves damaging red creep. Spawns a Leper head chunk and Gusher upon death.
Mushroom
Mushroom
Stationary enemy that occasionally pops up and fires four shots in the cardinal or diagonal directions. Takes less damage while its head is down.
Ministro
Ministro
Hops towards Isaac, occasionally spitting out a cluster of disorganized shots.
Mr. Mine
Mr. Mine
Can only appear in pits. Attempts to launch itself at Isaac if he comes near. Occasionally burrows and pops up in another pit, and fires six shots in all directions upon death.
Mr. Red Maw
Mr. Red Maw
Walks towards Isaac and attacks by launching its head towards Isaac. Turns into a Red Maw or Gusher upon death depending on the killed body segment. Occasionally separates at will.
Nerve Ending 2
Nerve Ending 2
Static enemy which whips at Isaac if he gets too close.
Poison Mind
Poison Mind
Slowly crawls around the room diagonally, leaving a trail of green creep.
Portal
Portal
Spawns various enemies from the current floor until it either vanishes or is killed.
Soul Sucker
Soul Sucker
Flies slowly towards Isaac. Spawns a vortex that fires four Brimstone beams in the cardinal directions upon death.
Stoney
Stoney
Chases Isaac and blocks tears, but does not deal contact damage. Temporarily pauses in exhaustion after a certain amount of time. Invulnerable; dies when the room is cleared.
Tar Boy
Tar Boy
Pops out of the ground in random locations and fires a short-ranged spray of shots that leave behind slowing black creep. If Isaac stands in the creep, the Tar Boy can fire shots straight upwards out of the creep underneath Isaac.
The Thing
The Thing
Crawls along a wall and attempts to line up with Isaac, then spits a line of damaging red creep.
Tube Worm
Tube Worm
Pops out of the ground in random locations and fires a long-range spray of arcing shots.

Bosses[edit | edit source]

5 bosses were added in Afterbirth †. Additionally, Ultra Greed received a second form in Greed Mode's hard mode.

Boss Rag Mega.png
Boss Big Horn.png
Boss Sisters Vis.png
Boss The Matriarch.png
Rag Mega Big Horn Sisters Vis The Matriarch
Boss Delirium.png
Boss Ultra Greedier.png
Delirium Ultra Greedier

Environment[edit | edit source]

Chapters[edit | edit source]

The Void.png
The Void

Obstacles[edit | edit source]

Super Special Rocks.png Super special rock
  • Super special rocks are tinted rock variants which are much harder to spot, as they have a smaller mark and are not discolored. Super special rocks takes two bombs to blow up, and drop the contents of two tinted rocks.
WhitePoop.png White poop
  • White poop is surrounded by an aura that halves tear delay and has a high chance to block damage like the Cone Head Cone Head
    Cone Head Icon.pngGrants a soul heart. Adds a chance to block enemy shots.
    item while Isaac stands within it. The aura disappears if the poop is destroyed.
DirtPatch.pngDirtPatchForgotten.png Dirt patch
  • Dirt Patches are a small mound of dirt that can be dug into with certain items. Using Mom's Shovel Mom's Shovel
    Mom's Shovel Icon.png4 roomsSpawns a trapdoor that leads to the next floor upon activation. Unlocks The Forgotten when used on a mound of dirt that appears in The Dark Room.
    on top of a dirt patch will reveal a skeleton and unlock The Forgotten. Once The Forgotten is unlocked, using Mom's Shovel, We Need to Go Deeper! We Need to Go Deeper!
    We Need to Go Deeper! Icon.png6 roomsCreates a trapdoor to go to the next floor. If used in The Womb, it will create a trapdoor to Sheol, even if the player hasn't unlocked it.
    , or Ehwaz Ehwaz
    Ehwaz Icon.pngCreates a trapdoor leading to the next floor. Has an estimated 1/12 (8%) chance to spawn a door to a Crawl Space instead.
    on top of a dirt patch will dig up a random chest.

Machines[edit | edit source]

Dressing Table.png Mom's Dressing Table

Challenges[edit | edit source]

Name Conditions Goal Unlocked by Unlocks

Unknown display mode [Backasswards] Unknown display mode [Aprils Fool] Unknown display mode [Pokey Mans] Unknown display mode [Ultra Hard] Unknown display mode [Pong]

Achievements[edit | edit source]

Name Image Description Unlock In Game Secret Number Platforms
Backasswards Backasswards Unlocked a new challenge. Defeat ??? or The Lamb for the 1st time 277
Aprils fool Aprils fool Unlocked a new challenge. Defeat Mom for the 1st time 278
Pokey Mans Pokey Mans Unlocked a new challenge. Defeat Mom's Heart 11 times 279
Ultra Hard Ultra Hard Unlocked a new challenge. Defeat ??? or The Lamb for the first time 280
PONG PONG Unlocked a new challenge. Defeat Isaac 5 times 281
D Infinity D Infinity Unlocked a new item. Defeat Delirium as Isaac 282
Eucharist Eucharist Unlocked a new item. Defeat Delirium as Magdalene 283
Silver Dollar Silver Dollar Unlocked a new item. Defeat Delirium as Cain 284
Shade Shade Unlocked a new item. Defeat Delirium as Judas 285
King Baby King Baby Unlocked a new co-player baby. Defeat Delirium as ??? 286
Bloody Crown Bloody Crown Unlocked a new item. Defeat Delirium as Samson 287
Dull Razor Dull Razor Unlocked a new item. Defeat Delirium as Eve 288
Eden's Soul Eden's Soul Unlocked a new item. Defeat Delirium as Eden 289
Dark Prince's Crown Dark Prince's Crown Unlocked a new item. Defeat Delirium as Azazel 290
Compound Fracture Compound Fracture Unlocked a new item. Defeat Delirium as Lazarus 291
Euthanasia Euthanasia Unlocked a new item. Defeat Delirium as Lilith 292
Holy Card Holy Card Unlocked a new item. Defeat Delirium as The Lost 293
Crooked Penny Crooked Penny Unlocked a new item. Defeat Delirium as Keeper 294
Void Void Unlocked a new item. Defeat Delirium as Apollyon 295
D1 D1 Unlocked a new item. Defeat Ultra Greedier as Isaac 296
Glyph of Balance Glyph of Balance Unlocked a new item. Defeat Ultra Greedier as Magdalene 297
Sack of Sacks Sack of Sacks Unlocked a new item. Defeat Ultra Greedier as Cain 298
Eye of Belial Eye of Belial Unlocked a new item. Defeat Ultra Greedier as Judas 299
Meconium Meconium Unlocked a new item. Defeat Ultra Greedier as ??? 300
Stem Cell Stem Cell Unlocked a new item. Defeat Ultra Greedier as Samson 301
Crow Heart Crow Heart Unlocked a new item. Defeat Ultra Greedier as Eve 302
Metronome Metronome Unlocked a new item. Defeat Ultra Greedier as Eden 303
Bat Wing Bat Wing Unlocked a new item. Defeat Ultra Greedier as Azazel 304
Plan C Plan C Unlocked a new item. Defeat Ultra Greedier as Lazarus 305
Duality Duality Unlocked a new item. Defeat Ultra Greedier as Lilith 306
Dad's Lost Coin Dad's Lost Coin Unlocked a new item. Defeat Ultra Greedier as The Lost 307
Eye of Greed Eye of Greed Unlocked a new item. Defeat Ultra Greedier as Keeper 308
Black Rune Black Rune Unlocked a new item. Defeat Ultra Greedier as Apollyon 309
Locust of War Locust of Wrath Unlocked a new item. Defeat Isaac as Apollyon 310
Locust of Pestilence Locust of Pestilence Unlocked a new item. Defeat Satan as Apollyon 311
Locust of Famine Locust of Famine Unlocked a new item. Defeat ??? as Apollyon 312
Locust of Death Locust of Death Unlocked a new item. Defeat The Lamb as Apollyon 313
Locust of Conquest Locust of Conquest Unlocked a new item. Complete the Boss Rush as Apollyon 314
Hushy Hushy Unlocked a new item. Defeat Hush as Apollyon 315
Brown Nugget Brown Nugget Unlocked a new item. Defeat Ultra Greed as Apollyon 316
Mort Baby Mort Baby Unlocked a new co-player baby. Defeat Mega Satan as Apollyon 317
Smelter Smelter Unlocked a new item. Defeat Mom's Heart or It Lives! on hard mode as Apollyon 318
Apollyon Baby Apollyon Baby Unlocked a new co-player baby. Earn all Hard Mode Completion Marks as Apollyon 319
New Area New Area Unlocked a new area. Defeat Hush for the 1st time 320
Once More with Feeling! Once More with Feeling! Unlocked a new item. Complete a Victory Lap, defeating The Lamb 321
Hat trick! Hat trick! Unlocked a new item. Get a 3-win streak 322
5 Nights at Mom's 5 Nights at Mom's Unlocked super special rocks. Get a 5-win streak, using a different character for each win 323
Sin collector Sin collector Unlocked a new item. Collect every entry in the Bestiary (Bugged v190 - Mobs that don't exist in the bestiary are being counted. This allows Sin Collector to be unlocked without a complete bestiary) 324
Dedication Dedication Unlocked a new item. Participate in 31 Daily Challenges (they don't have to be consecutive; it will still count if you die in the first room) 325
ZIP! ZIP! Unlocked a new item. Defeat The Lamb in under 20 minutes 326
It's the Key It's the Key Unlocked a new item. Defeat The Lamb without taking hearts, coins, and bombs through an entire run 327
Mr. Resetter! Mr. Resetter! Unlocked a new item. Reset 7 times in a row

 Switch   PS4  Get a minus 10-win streak

328
Living on the Edge Living on the edge Unlocked a new item. Complete a floor after Basement I, start-to-finish, with only half a heart of health (can use The Lost) 329
U Broke It! U Broke It! Unlocked a new item. Obtain 50 items on a run (e.g., via two Steam Sales and Restock - Duplicate passives/familiars count towards the total, e.g., multiple Breakfasts) 330
Laz Bleeds More! Laz Bleeds More! Unlocked a new starting item. Complete challenge #31 331
Maggy Now Holds a Pill! Maggy Now Holds a Pill! Unlocked a new starting item. Complete challenge #32 332
Charged Key Charged Key Unlocked a new item. Complete challenge #33 333
Samson Feels Healthy! Samson Feels Healthy! Unlocked a new starting item. Complete challenge #34 334
Greed's Gullet Greed's Gullet Unlocked a new item. Complete challenge #35 335
The Marathon The Marathon Unlocked a new item. Get a 5-win streak in the Daily Challenges 336
RERUN RERUN Unlocked the power of RERUN. Complete 3 Victory Laps and start a 4th 337
Delirious Delirious Unlocked a new item. Defeat Delirium for the first time as any character 338
1000000% 1000000% Just Stop! Collect every item in the game, unlock all secrets and endings, and complete the Bestiary 339
Apollyon Apollyon Unlocked a new character. Defeat Mega Satan for the 1st time 340
Greedier! Greedier! New mode unlocked! Donate 500 coins to the Greed Machine 341
Burning Basement Burning Basement Alt stage to the basement. Defeat Mom's Heart 11 times 342
Flooded Caves Flooded Caves Alt stage to the caves. Defeat It Lives 16 times 343
Dank Depths Dank Depths Alt stage to the depths. Defeat It Lives 21 times 344
Scarred Womb Scarred Womb Alt stage to the womb. Defeat It Lives 30 times 345
Something wicked this way comes! Something wicked this way comes! Unlocked new bosses! Defeat ??? as 3 different characters 346
Something wicked this way comes+! Something wicked this way comes+! Unlocked even more bosses! Defeat ??? as 6 different characters 347
The gate is open! The gate is open! Unlocked new enemies! Defeat The Lamb for the 1st time 348
Black Hole Black Hole Unlocked a new item. Defeat 20 portals 349
Mystery Gift Mystery Gift Unlocked a new item. Destroy 500 rocks 350
Sprinkler Sprinkler Unlocked a new item. Beat chapter 1 without taking damage 351
Angry Fly Angry Fly Unlocked a new item. Become Beelzebub 352
Bozo Bozo Unlocked a new item. Destroy 5 rainbow poops 353
Broken Modem Broken Modem Unlocked a new item. Complete 7 (30 on console) daily challenges (by touching the trophy at the end)
354
Buddy in a Box Buddy in a Box Unlocked a new item. Pick up 5 familiars in a single run 355
Fast Bombs Fast Bombs Unlocked a new item. Defeat Little Horn 20 times 356
Lil Delirium Lil Delirium Unlocked a new item. Defeat Delirium for the 1st time 357
Hairpin Hairpin Unlocked a new item. Recharge using batteries 20 times 358
Wooden Cross Wooden Cross Unlocked a new item. Sleep in a bed 359
Butter! Butter! Unlocked a new item. Complete 2 Victory Laps and start a 3rd 360
Huge Growth Huge Growth Unlocked a new item. Increase in size 5 times in a single run. Sources of increased size include "One Makes you Larger" pills, XI - Strength, and Magic Mushroom 361
Ancient Recall Ancient Recall Unlocked a new item. Use cards and runes 20 times 362
Era Walk Era Walk Unlocked a new item. Have both the Broken Watch and the Stop Watch in your collection 363
Coupon Coupon Unlocked a new item. Purchase from shops 50 times 364
Telekinesis Telekinesis Unlocked a new item. Beat Chapter 2 without taking damage 365
Moving Box Moving Box Unlocked a new item. Use Pandora's Box in the Dark Room 366
Jumper Cables Jumper Cables Unlocked a new item. Pick up any 3 of the following items/trinkets in a single run: 9 Volt, The Battery, Car Battery, AAA Battery, Watch Battery 367
Leprosy Leprosy Unlocked a new item. Beat Chapter 3 without taking damage 368
Technology Zero Technology Zero Unlocked a new item. Pick up two technology items in one run 369
Filigree Feather Filigree Feather Unlocked a new item. Acquire both key pieces 370
Mr. ME! Mr. ME! Unlocked a new item. Open 20 locked chests 371
7 Seals 7 Seals Unlocked a new item. Defeat all 5 Harbingers 372
Angelic Prism Angelic Prism Unlocked a new item. Defeat an Angel 10 times 373
Pop! Pop! Unlocked a new item. Beat Chapter 4 without taking damage 374
Door Stop Door Stop Unlocked a new item. Blow up doors and secret room walls 50 times 375
Death's List Death's List Unlocked a new item. Take 25 devil deals 376
Haemolacria Haemolacria Unlocked a new item. Acquire Blood Clot 10 times 377
Lachryphagy Lachryphagy Unlocked a new item. Collect 10 "tears up" items or pills in one run 378
Schoolbag Schoolbag Unlocked a new item. Enter every shop from Chapter 1 through Chapter 3 in one run 379
Trisagion Trisagion Unlocked a new item. Take 25 items from Angel rooms 380
Extension Cord Extension Cord Unlocked a new item. Have The Battery, 9 Volt, and Car Battery in your collection 381
Flat Stone Flat Stone Unlocked a new item. Acquire Rubber Cement 5 times 382
Sacrificial Altar Sacrificial Altar Unlocked a new item. Take 50 devil deals 383
Lil Spewer Lil Spewer Unlocked a new item. Die to your own explosion from Ipecac, Bob's Rotten Head, or Horf! pill 384
Blanket Blanket Unlocked a new item. Sleep in 10 beds 385
Marbles Marbles Unlocked a new item. Use 5 Gulp! pills in one run 386
Mystery Egg Mystery Egg Unlocked a new item. Spawn three charmed enemies in the same room 387
Rotten Penny Rotten Penny Unlocked a new item. Have 20 blue flies at the same time 388
Baby-Bender Baby-Bender Unlocked a new item. Use I - The Magician or Telepathy for Dummies while already having homing tears (Sources of this effect include I - The Magician, Telepathy for Dummies, Spoon Bender, Sacred Heart, or Godhead). 389
The Forgotten The Forgotten Unlocked a new character. It's complicated 390
Bone Heart Bone Heart Unlocked a new item. It's complicated 391
Marrow Marrow Unlocked a new item. Defeat Mom's Heart or It Lives! on hard mode as The Forgotten 392
Slipped Rib Slipped Rib Unlocked a new item. Defeat Isaac as The Forgotten 393
Pointy Rib Pointy Rib Unlocked a new item. Defeat Satan as The Forgotten 394
Jaw Bone Jaw Bone Unlocked a new item. Defeat ??? as The Forgotten 395
Brittle Bones Brittle Bones Unlocked a new item. Defeat The Lamb as The Forgotten 396
Divorce Papers Divorce Papers Unlocked a new item. Complete the Boss Rush as The Forgotten 397
Hallowed Ground Hallowed Ground Unlocked a new item. Defeat Hush as The Forgotten 398
Finger Bone Finger Bone Unlocked a new item. Defeat Ultra Greed as The Forgotten 399
Dad's Ring Dad's Ring Unlocked a new item. Defeat Ultra Greedier as The Forgotten 400
Book of the Dead Book of the Dead Unlocked a new item. Defeat Delirium as The Forgotten 401
Bone Baby Bone Baby Unlocked a new co-player baby. Earn all Hard Mode Completion Marks as The Forgotten 402
Bound Baby Bound Baby Unlocked a new co-player baby. Defeat Mega Satan as The Forgotten 403

Changes[edit | edit source]

Menus[edit | edit source]

Collection page
  • The navigation is faster and loops back on itself when scrolling vertically.
Loading screen
  • Loading images are smoother.

Player[edit | edit source]

Characters[edit | edit source]

General
  • Adjusted the stats of each character in the character selection menu to better reflect their actual in-game stats.
  • Adjusted pickup animation so items no longer obstruct his face.
  • Blood on costumes are now consistently the same color.
Eden
  • Holding R to reset will consume an Eden Token and start a new run.
  • Added 30 hairstyles.
  • Can be randomed if the player has Eden tokens.
Eve
  • Starts with Razor Blade only if it has been unlocked.
  • Leaves a pool of blood behind instead of pee when walking between rooms at low HP.
Lilith

Transformations[edit | edit source]

Conjoined
  • Its costume has color alts.
Seraphim
  • Its costume has color alts.
Spun
  • Its costume has color alts.
Yes Mother?
  • Its costume has color alts.

Familiars[edit | edit source]

  • Teleport to the player's new position if it was changed by a boss such as Gurdy or Mom's Heart.
  • Most sources of blue spiders throw those spiders out instead of spawning them on the ground.
  • Following familiars are no longer pushed back when very close to the player.

Co-op[edit | edit source]

  • Co-op babies can no longer drop out while the player is playing a pickup animation.

Items[edit | edit source]

General
  • Mushroom items play their unique pickup sound.

Activated Collectibles[edit | edit source]

General
  • Some sprites changed:
Item Old sprite New sprite
The Boomerang The Boomerang Rebirth Icon.png The Boomerang Icon.png
Box of Spiders Box of Spiders Rebirth Icon.png Box of Spiders Icon.png
D20 D20 Rebirth Icon.png D20 Icon.png
D7 D7 Afterbirth Icon.png D7 Icon.png
Glass Cannon Glass Cannon Afterbirth Icon.png Glass Cannon Icon.png
Isaac's Tears Isaac's Tears Rebirth Icon.png Isaac's Tears Icon.png
The Jar The Jar Rebirth Icon.png The Jar Icon.png
Jar of Flies Jar of Flies Afterbirth Icon.png Jar of Flies Icon.png
Mega Blast Mega Blast Afterbirth Icon.png Mega Blast Icon.png
Ventricle Razor Ventricle Razor Afterbirth Icon.png Ventricle Razor Icon.png
We Need to Go Deeper! We Need to Go Deeper! Rebirth Icon.png We Need to Go Deeper! Icon.png
Breath of Life Breath of Life
Breath of Life Icon.png6 secondsGrants a brief moment of invincibility when the charge bar hits zero. If spacebar is held for an additional second after hitting zero, Isaac will take damage.
  • Can be held down between rooms.
  • Added some visual feedback when it provides its invincibility.
Butter Bean Butter Bean
Butter Bean Icon.png3 secondsIsaac farts and pushes back nearby enemies.
  • If Isaac swaps Butter Bean for a different active item, then picks up Butter Bean again, it has a small chance to transform into Wait What?.
D4 D4
D4 Icon.png6 roomsRerolls all of Isaac's items.
  • Re-rolls each of Isaac's passive items into a random item from the specific item pool where it was acquired.
Diplopia Diplopia
Diplopia Icon.pngOne time useDuplicates all pickups and item pedestals in the room.
  • No longer spawns extra items for empty item pedestals.
Flush! Flush!
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.
  • Poops spawned react to damage similarly to regular poops.
Friendly Ball Friendly Ball
Friendly Ball Icon.png3 roomsThrowing the ball at an enemy instantly kills it and captures it. The captured enemy can later be released and will be charmed until it dies, persisting between floors.
Glowing Hour Glass Glowing Hour Glass
Glowing Hour Glass Icon.png2 roomsWhen 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.
Guppy's Head Guppy's Head
Guppy's Head Icon.png1 roomsSpawns 2-4 blue flies to damage enemies.
  • The number of flies is seeded.
Head of Krampus Head of Krampus
Head of Krampus Icon.png6 roomsFires a cross-patterned brimstone shot, just like The Fallen and Krampus shoot.
  • Lasers no longer have a chance to rotate.
The Jar The Jar
The Jar Icon.pngUnlimitedWhen at full health, up to 4 extra hearts can be stored in the jar.
  • Its sprite changes based on how many hearts it contains.
Jar of Flies Jar of Flies
Jar of Flies Icon.pngUnlimitedEvery 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.
  • Its sprite changes based on how many flies it contains.
Mine Crafter Mine Crafter
Mine Crafter Icon.png1 roomsWhen used, places an explosive TNT barrel that can be pushed and used to destroy rocks or damage enemies. If used a second time in the same room while the previous TNT barrel is still intact, it will remotely explode the TNT.
  • Spawns a TNT barrel directly at the player's position rather than on a nearby free tile.
My Little Unicorn My Little Unicorn
My Little Unicorn Icon.png6 roomsUpon use, grants invulnerability and increased speed for five seconds, removing the ability to shoot tears and replacing it with the ability to deal contact damage to enemies.
  • Its costume has color alts.
Pandora's Box Pandora's Box
Pandora's Box Icon.pngOne time useUpon use, spawns certain pickups or items depending on the floor it is used on. Single-use.
Satanic Bible Satanic Bible
Satanic Bible Icon.png6 roomsUpon activation, Isaac gains a black heart.
  • Plays its use animation.
Shoop Da Whoop! Shoop Da Whoop!
Shoop Da Whoop! Icon.png2 roomsFires a laser from Isaac's mouth.
  • Damage halved to compensate.
Undefined Undefined
Undefined Icon.png6 roomsTeleports Isaac to either the Secret Room, Super Secret Room, Treasure Room, or I AM ERROR.
  • The Void is reset on exiting the I AM ERROR room, and can be cleared repeatedly as long as the player is able to gather enough charges to successfully warp to it.
Ventricle Razor Ventricle Razor
Ventricle Razor Icon.pngUnlimitedCan be used to place an orange portal and a blue portal. Upon entering a portal, Isaac is teleported to the other portal.
  • Portals will now appear closed if they have no connected portal.
  • Portals got a few minor visual tweaks.

Passive Collectibles[edit | edit source]

General
  • Some sprites changed:
Item Old sprite New sprite
<3 Less Than Three Rebirth Icon.png Less Than Three Icon.png
8 Inch Nails 8 Inch Nails Afterbirth Icon.png 8 Inch Nails Icon.png
Abaddon Abaddon Rebirth Icon.png Abaddon Icon.png
Anemic Anemic Rebirth Icon.png Anemic Icon.png
Aquarius Aquarius Rebirth Icon.png Aquarius Icon.png
The Belt The Belt Rebirth Icon.png The Belt Icon.png
Best Bud Best Bud Rebirth Icon.png Best Bud Icon.png
Black Lotus Black Lotus Rebirth Icon.png Black Lotus Icon.png
Bob's Curse Bob's Curse Rebirth Icon.png Bob's Curse Icon.png
Box Box Rebirth Icon.png Box Icon.png
Brimstone Brimstone Rebirth Icon.png Brimstone Icon.png
Brother Bobby Brother Bobby Rebirth Icon.png Brother Bobby Icon.png
Bum Friend Bum Friend Rebirth Icon.png Bum Friend Icon.png
Caffeine Pill Caffeine Pill Rebirth Icon.png Caffeine Pill Icon.png
Cambion Conception Cambion Conception Afterbirth Icon.png Cambion Conception Icon.png
Cancer Cancer Rebirth Icon.png Cancer Icon.png
Celtic Cross Celtic Cross Rebirth Icon.png Celtic Cross Icon.png
The Compass The Compass Rebirth Icon.png The Compass Icon.png
Continuum Continuum Afterbirth Icon.png Continuum Icon.png
Cricket's Head Cricket's Head Rebirth Icon.png Cricket's Head Icon.png
Crown of Light Crown of Light Afterbirth Icon.png Crown of Light Icon.png
Cupid's Arrow Cupid's Arrow Rebirth Icon.png Cupid's Arrow Icon.png
Daddy Longlegs Daddy Longlegs Rebirth Icon.png Daddy Longlegs Icon.png
Dark Bum Dark Bum Rebirth Icon.png Dark Bum Icon.png
Demon Baby Demon Baby Rebirth Icon.png Demon Baby Icon.png
Distant Admiration Distant Admiration Rebirth Icon.png Distant Admiration Icon.png
Evil Eye Evil Eye Afterbirth Icon.png Evil Eye Icon.png
Farting Baby Farting Baby Afterbirth Icon.png Farting Baby Icon.png
Forever Alone Forever Alone Rebirth Icon.png Forever Alone Icon.png
Friend Zone Friend Zone Afterbirth Icon.png Friend Zone Icon.png
Gemini Gemini (Item) Rebirth Icon.png Gemini (Item) Icon.png
Ghost Baby Ghost Baby Rebirth Icon.png Ghost Baby Icon.png
Goat Head Goat Head Rebirth Icon.png Goat Head Icon.png
Guppy's Hair Ball Guppy's Hair Ball Rebirth Icon.png Guppy's Hair Ball Icon.png
Habit Habit Rebirth Icon.png Habit Icon.png
Harlequin Baby Harlequin Baby Rebirth Icon.png Harlequin Baby Icon.png
Holy Water Holy Water Rebirth Icon.png Holy Water Icon.png
Infestation Infestation Rebirth Icon.png Infestation Icon.png
Key Bum Key Bum Afterbirth Icon.png Key Bum Icon.png
Key Piece 2 Key Piece 2 Rebirth Icon.png Key Piece 2 Icon.png
Lil Brimstone Lil Brimstone Rebirth Icon.png Lil Brimstone Icon.png
Lil' Loki Lil' Loki Afterbirth Icon.png Lil' Loki Icon.png
Lord of the Pit Lord of the Pit Rebirth Icon.png Lord of the Pit Icon.png
Lost Fly Lost Fly Afterbirth Icon.png Lost Fly Icon.png
Lucky Foot Lucky Foot Rebirth Icon.png Lucky Foot Icon.png
Magic 8 Ball Magic 8 Ball Rebirth Icon.png Magic 8 Ball Icon.png
Magneto Magneto Rebirth Icon.png Magneto Icon.png
Mitre Mitre Rebirth Icon.png Mitre Icon.png
Mom's Contacts Mom's Contacts Rebirth Icon.png Mom's Contacts Icon.png
Mom's Eye Mom's Eye Rebirth Icon.png Mom's Eye Icon.png
Mom's Knife Mom's Knife Rebirth Icon.png Mom's Knife Icon.png
Money = Power Money = Power Rebirth Icon.png Money = Power Icon.png
The Mulligan The Mulligan Rebirth Icon.png The Mulligan Icon.png
Multidimensional Baby Multidimensional Baby Afterbirth Icon.png Multidimensional Baby Icon.png
The Peeper The Peeper Rebirth Icon.png The Peeper Icon.png
Pentagram Pentagram Rebirth Icon.png Pentagram Icon.png
Piggy Bank Piggy Bank Rebirth Icon.png Piggy Bank Icon.png
Polyphemus Polyphemus Rebirth Icon.png Polyphemus Icon.png
Proptosis Proptosis Rebirth Icon.png Proptosis Icon.png
Pyro Pyro Rebirth Icon.png Pyro Icon.png
Rainbow Baby Rainbow Baby Rebirth Icon.png Rainbow Baby Icon.png
Robo-Baby Robo-Baby Rebirth Icon.png Robo-Baby Icon.png
Robo-Baby 2.0 Robo-Baby 2.0 Rebirth Icon.png Robo-Baby 2.0 Icon.png
Rotten Baby Rotten Baby Rebirth Icon.png Rotten Baby Icon.png
Sacrificial Dagger Sacrificial Dagger Rebirth Icon.png Sacrificial Dagger Icon.png
Sad Bombs Sad Bombs Rebirth Icon.png Sad Bombs Icon.png
Sagittarius Sagittarius Rebirth Icon.png Sagittarius Icon.png
Sister Maggy Sister Maggy Rebirth Icon.png Sister Maggy Icon.png
Skeleton Key Skeleton Key Rebirth Icon.png Skeleton Key Icon.png
SMB Super Fan SMB Super Fan Rebirth Icon.png SMB Super Fan Icon.png
Spear of Destiny Spear of Destiny Afterbirth Icon.png Spear of Destiny Icon.png
Speed Ball Speed Ball Rebirth Icon.png Speed Ball Icon.png
Spirit of the Night Spirit of the Night Rebirth Icon.png Spirit of the Night Icon.png
Strange Attractor Strange Attractor Rebirth Icon.png Strange Attractor Icon.png
Taurus Taurus Rebirth Icon.png Taurus Icon.png
Tech.5 Tech.5 Rebirth Icon.png Tech.5 Icon.png
Tough Love Tough Love Rebirth Icon.png Tough Love Icon.png
Whore of Babylon Whore of Babylon Rebirth Icon.png Whore of Babylon Icon.png
Ball of Bandages Ball of Bandages
Ball of Bandages Icon.pngOrbiting familiar that deals damage to enemies. If collected while already having one, makes the familiar evolve. Only drops from Horsemen. Similar to Cube of Meat.
  • Decreased the damage rate of level 3 and 4 to match Cube of Meat.
The Battery The Battery
The Battery Icon.pngActivated Items can be "overcharged" to allow for an additional use.
  • Self-recharging active items can charge the yellow meter, allowing Isaac to use them twice immediately.
Betrayal Betrayal
Betrayal Icon.pngEvery time Isaac takes damage, a charm effect is applied to every enemy in the room, causing them to attack each other rather than Isaac.
  • No longer triggers if there are less than 2 enemies in the room.
  • Its costume has color alts.
BFFS! BFFS!
BFFS! Icon.pngIncreases the size and damage of familiars.
  • Increases spawner familiar spawn rates.
Black Candle Black Candle
Black Candle Icon.pngPrevents curses. Grants one black heart. Increases the chance for a Devil or angel room to appear.
  • Makes the darkness from Curse of Darkness fade away instead of immediately lighting the room up.
The Body The Body
The Body Icon.pngAdds 3 heart containers.
  • Its costume has color alts.
Bogo Bombs Bogo Bombs
Bogo Bombs Icon.pngAll standard bomb pickups become 1+1 bomb pickups.
  • Its costume has color alts.
Bursting Sack Bursting Sack
Bursting Sack Icon.pngSpider enemies no longer target or deal contact damage to Isaac.
  • Its costume has color alts.
Cancer Cancer
Cancer (Trinket) Icon.png-2 Tear Delay (effectively increases firerate of tears).
  • Its costume has color alts.
Dead Eye Dead Eye
Dead Eye Icon.pngIsaac's damage increases each time an enemy is hit. Damage is reset upon missing a shot.
  • The multiplier will no longer be lost when hitting poops or TNT barrels.
E Coli E Coli
E Coli Icon.pngGives "Turdy Touch" Effect. Enemies that touch Isaac are changed into poop.
  • Poops spawned react to damage similarly to regular poops.
Eden's Blessing Eden's Blessing
Eden's Blessing Icon.png+0.7 tears up. Grants a random item at the start of the next run.
  • Is now limited to a maximum of 10 to prevent potential crashes.
Epiphora Epiphora
Epiphora Icon.pngShooting 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.
  • Being hit, changing rooms, and using items no longer reset the Epiphora bonus.
    • During the delay when transitioning between rooms, picking up an item, or using an active item, it's possible to change firing direction without resetting the bonus.
Fate Fate
Fate Icon.pngGrants flight and one eternal heart.
  • Its costume has color alts.
Fruit Cake Fruit Cake
Fruit Cake Icon.pngIsaac's tears gain a random effect that changes every shot.
Gemini Gemini
Gemini (Item) Icon.pngSuture becomes attached to Isaac, and does touch damage to enemies within its attacking range.
  • Added extra familiar animations.
Hive Mind Hive Mind
Hive Mind Icon.pngIncreases the size of blue spiders and Blue Flies and doubles the amount of damage they deal.
  • The effect also applies to locusts.
Holy Grail Holy Grail
Holy Grail Icon.pngGrants flight and one heart container.
  • Its costume has color alts.
Holy Mantle Holy Mantle
Holy Mantle Icon.pngAutomatically negates first taken damage in every room.
  • The shield is no longer restored if the player saves and continues after losing it.
Immaculate Conception Immaculate Conception
Immaculate Conception Icon.pngUpon picking up a certain amount of health, spawn a permanent angelic familiar.
  • Its costume has color alts.
Key Piece 1 Key Piece 1
Key Piece 1 Icon.pngCombined with Key Piece 2, unlocks the golden gate in the starting room of The Chest and Dark Room to fight Mega Satan.
/ Key Piece 2 Key Piece 2
Key Piece 2 Icon.pngCombined with Key Piece 1, unlocks the golden gate in the starting room of The Chest and Dark Room to fight Mega Satan.
Kidney Stone Kidney Stone
Kidney Stone Icon.pngRandomly 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.
  • Causes Isaac to fire "tears" from the middle instead of from his eyes, and at a slightly lower height.
Lil Brimstone Lil Brimstone
Lil Brimstone Icon.pngA Familiar that shoots a thin Brimstone beam. Must charge like Brimstone before shooting.
  • Got renamed from "Lil' Brimstone" to "Lil Brimstone".
  • Can damage fireplaces and poops.
Lil Haunt Lil Haunt
Lil Haunt Icon.pngA familiar that damages enemies by chasing them as well as inducing the fear effect.
  • Got renamed from "Lil' Haunt" to "Lil Haunt".
Lord of the Pit Lord of the Pit
Lord of the Pit Icon.pngGrants flight and increases speed.
  • Its costume has color alts.
Lost Contact Lost Contact
Lost Contact Icon.pngEvery tear has a small shield which will allow it to block one enemy projectile.
  • Only affects the player and Incubus's tears.
Lusty Blood Lusty Blood
Lusty Blood Icon.pngEach time Isaac kills an enemy, Isaac's damage increases for the current room.
  • Its costume has color alts.
Number One Number One
Number One Icon.png+1.5 tears, -15.77 range
  • Causes Isaac to fire "tears" from the middle instead of from his eyes, and at a slightly lower height.
Ouija Board Ouija Board
Ouija Board Icon.pngGrants spectral tears that travel through obstacles (but not enemies) instead of breaking on impact with them.
  • Its costume no longer overwrites the player's skin color to pink instead of white.
PHD PHD
PHD Icon.pngConverts all bad pills into good pills, spawns one pill pickup and restores health. Identifies all pills upon pickup.
  • Converts:
    • ??? into Telepills
    • Addicted into Percs!
    • Paralysis into Pheromones
    • Retro Vision into I can see forever!
    • R U A Wizard? into Power Pill!
    • X-Lax into Something's wrong...
Piggy Bank Piggy Bank
Piggy Bank Icon.pngGives 3 pennies on pick-up. Every time Isaac is damaged, he will drop one additional penny.
  • Its costume has color alts.
Purity Purity
Purity Icon.pngThis item will boost one of Isaac's stats depending on the color of the aura around him. The aura will disappear upon taking damage and will reappear with a random color upon entering a new room. A red aura boosts damage, a blue aura boosts rate of fire, a yellow aura boosts speed, and an orange aura boosts range.
  • Better visualisation of Purity's glow.
Restock Restock
Restock Icon.pngCauses shops to instantly restock their items when they are bought. Granted by default for every character in Greed Mode.
  • Purchasing an item that is on sale will replace it with another that is on sale.
Robo-Baby Robo-Baby
Robo-Baby Icon.pngFollows Isaac around, shooting enemies with an eye laser similar to Technology.
Rubber Cement Rubber Cement
Rubber Cement Icon.pngTears bounce off walls, enemies, and environmental objects.
  • Tears bounce off bombs.
  • Spectral tears no longer bounce off rocks.
Sagittarius Sagittarius
Sagittarius Icon.pngIncreases speed by +0.2 and grants piercing tears.
  • Its costume has color alts.
Scatter Bombs Scatter Bombs
Scatter Bombs Icon.pngAdds 5 bombs. Isaac's bombs explode into 2-4 tiny bombs.
  • Bombs actually scatter around.
  • Small bombs leave smaller craters.
The Small Rock The Small Rock
The Small Rock Icon.pngIncreases damage by 1, increases tears by 0.2, and decreases speed by 0.1.
  • The speed and tears changes will take effect immediately. Without Afterbirth+, they didn't immediately change until Isaac's speed or tears stats are updated the next time.
Steam Sale Steam Sale
Steam Sale Icon.pngReduces all Shop prices by 50%, rounded down to 7 coins for an item, rounded up to 2-3 coins for a pickup.
  • Items have a chance to be discounted further by random sales; for example, a discounted item originally costing 5 coins will then cost 2 coins instead of 3.
Sticky Bombs Sticky Bombs
Sticky Bombs Icon.png+5 bombs. Bombs stick to enemies and spawn 2-4 blue spiders if they kill an enemy.
  • Its costume has color alts.
Succubus Succubus
Succubus Icon.pngSpawns 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.
Synthoil Synthoil
Synthoil Icon.pngIncreases damage by 1, range by 5.25, and tear height by 0.5.
  • Its costume has color alts.

Trinkets[edit | edit source]

General
  • Some sprites changed:
Item Old sprite New sprite
???'s Soul Blue Baby's Soul Rebirth Icon.png Blue Baby's Soul Icon.png
Black Feather Black Feather Afterbirth Icon.png Black Feather Icon.png
Blasting Cap Blasting Cap Afterbirth Icon.png Blasting Cap Icon.png
Blister Blister Afterbirth Icon.png Blister Icon.png
Bob's Bladder Bob's Bladder Afterbirth Icon.png Bob's Bladder Icon.png
Broken Magnet Broken Magnet Rebirth Icon.png Broken Magnet Icon.png
Brown Cap Brown Cap Afterbirth Icon.png Brown Cap Icon.png
Cain's Eye Cain's Eye Rebirth Icon.png Cain's Eye Icon.png
Cracked Dice Cracked Dice Afterbirth Icon.png Cracked Dice Icon.png
Daemon's Tail Daemon's Tail Rebirth Icon.png Daemon's Tail Icon.png
Endless Nameless Endless Nameless Afterbirth Icon.png Endless Nameless Icon.png
Error 96px Error Icon.png
Karma Karma Afterbirth Icon.png Karma Icon.png
Lazy Worm Lazy Worm Afterbirth Icon.png Lazy Worm Icon.png
Lil Larva Lil Larva Afterbirth Icon.png Lil Larva Icon.png
Louse Louse Afterbirth Icon.png Louse Icon.png
Lucky Rock Lucky Rock Rebirth Icon.png Lucky Rock Icon.png
Mom's Locket Mom's Locket Afterbirth Icon.png Mom's Locket Icon.png
Mom's Pearl Mom's Pearl Rebirth Icon.png Mom's Pearl Icon.png
Mysterious Paper Mysterious Paper Rebirth Icon.png Mysterious Paper Icon.png
NO! NO! Afterbirth Icon.png NO! Icon.png
Poker Chip Poker Chip Afterbirth Icon.png Poker Chip Icon.png
Purple Heart Purple Heart Rebirth Icon.png Purple Heart Icon.png
Push Pin Push Pin Rebirth Icon.png Push Pin Icon.png
Rainbow Worm Rainbow Worm Afterbirth Icon.png Rainbow Worm Icon.png
Rib of Greed Rib of Greed Afterbirth Icon.png Rib of Greed Icon.png
Second Hand Second Hand Afterbirth Icon.png Second Hand Icon.png
Shiny Rock Shiny Rock Afterbirth Icon.png Shiny Rock Icon.png
Stud Finder Stud Finder Afterbirth Icon.png Stud Finder Icon.png
Super Magnet Super Magnet Afterbirth Icon.png Super Magnet Icon.png
Tape Worm Tape Worm Afterbirth Icon.png Tape Worm Icon.png
Umbilical Cord Umbilical Cord Rebirth Icon.png Umbilical Cord Icon.png
Watch Battery Watch Battery Afterbirth Icon.png Watch Battery Icon.png
Whip Worm Whip Worm Rebirth Icon.png Whip Worm Icon.png
The Left Hand The Left Hand
The Left Hand Icon.pngReplaces brown chests and golden chests with red chests.
Safety Scissors Safety Scissors
Safety Scissors Icon.pngTroll bombs turn into Bomb pickups before they explode. Mega troll bombs turn into 1+1 free bombs before they explode.
Tick Tick
Tick Icon.pngDrain 15% health of each enemy with more than 60 HP (ie. most bosses). Also restores one red heart of Isaac whenever he enters an uncleared boss room. The Tick cannot be swapped out for another trinket.

Interactions[edit | edit source]

  • Added in Afterbirth ? Card ? Card
    Q Card Icon.pngWhen used, copies the effect of Isaac's currently held activated collectible item.
    + Glowing Hour Glass Glowing Hour Glass
    Glowing Hour Glass Icon.png2 roomsWhen 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.
    - The ? Card doesn't get refunded upon usage anymore.
  • 9 Volt 9 Volt
    9 Volt Icon.pngReduces the charge of any Activated Items by 1. Any 1 charge items instead have timed recharges.
    + The Candle The Candle
    The Candle Icon.png4 secondsThrows out a blue flame that can pass over gaps (but not through rocks). The flame damages anything in its path.
    - The Candle starts at half charge after use.
  • A Lump of Coal A Lump of Coal
    A Lump of Coal Icon.pngThe more distance tears travel, the more damage they will do.
    + Athame Athame
    Athame Icon.pngWhenever Isaac takes damage, a black ring briefly appears around Isaac, dealing damage to all nearby enemies.
    - Damage to the ring of Athame is no longer reduced by half.
  • A Lump of Coal A Lump of Coal
    A Lump of Coal Icon.pngThe more distance tears travel, the more damage they will do.
    + Maw of the Void Maw of the Void
    Maw of the Void Icon.png+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.
    - Damage to the Maw ring is no longer reduced by half.
  • Athame Athame
    Athame Icon.pngWhenever Isaac takes damage, a black ring briefly appears around Isaac, dealing damage to all nearby enemies.
    + Proptosis Proptosis
    Proptosis Icon.pngTears start out massive with high damage, and then shrink down and become weaker over a short range.
    - The ring deals normal damage.
  • Brimstone Brimstone
    Brimstone Icon.pngTears are replaced by a laser beam that pierces through all enemies and obstacles in its path and deals high damage. Can only be fired after a short charge-up period.
    + Ipecac Ipecac
    Ipecac Icon.pngReplaces tears with explosive and poisoning projectiles fired in an arc from the mouth.
    - Isaac shoots Ipecac tears while charging Brimstone. Isaac gains increased damage, decreased tears, and the poison effect.
  • Car Battery Car Battery
    Car Battery Icon.pngCauses Isaac's activated item to activate twice on each use.
    + Mine Crafter Mine Crafter
    Mine Crafter Icon.png1 roomsWhen used, places an explosive TNT barrel that can be pushed and used to destroy rocks or damage enemies. If used a second time in the same room while the previous TNT barrel is still intact, it will remotely explode the TNT.
    - Spawns two TNT barrels.
  • Cursed Eye Cursed Eye
    Cursed Eye Icon.pngGrants charged tears that can be fired in a tight burst of four. Getting hit while charging will teleport Isaac into another room.
    + Incubus Incubus
    Incubus Icon.pngA demonic familiar that follows Isaac and shoots tears identical to Isaac's in terms of damage, range, fire rate, and effects.
    - A burst of tears is fired, but it does not need to be charged.
  • Epic Fetus Epic Fetus
    Epic Fetus Icon.pngIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
    + Monstro's Lung Monstro's Lung
    Monstro's Lung Icon.pngIncreases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.
    - As of current version this synergy is bugged and only a single missile fires.
  • Ipecac Ipecac
    Ipecac Icon.pngReplaces tears with explosive and poisoning projectiles fired in an arc from the mouth.
    + The Ludovico Technique The Ludovico Technique
    The Ludovico Technique Icon.pngInstead of firing tears, Isaac controls one floating tear that hover over obstacles. This tear deals constant damage when held in place over an enemy.
    - +4 damage bonus, no explosion.
  • Ipecac Ipecac
    Ipecac Icon.pngReplaces tears with explosive and poisoning projectiles fired in an arc from the mouth.
    + Mom's Knife Mom's Knife
    Mom's Knife Icon.pngIsaac's tears are replaced by a knife that pierces enemies, can travel through obstacles, and can hurt enemies while Isaac is holding it. Holding down the fire button before firing increases its range and power.
    - Also adds +4 damage.
  • The Ludovico Technique The Ludovico Technique
    The Ludovico Technique Icon.pngInstead of firing tears, Isaac controls one floating tear that hover over obstacles. This tear deals constant damage when held in place over an enemy.
    + Multidimensional Baby Multidimensional Baby
    Multidimensional Baby Icon.pngSpawns 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.
    - An additional Ludovico tear is spawned when it passes through Multidimensional Baby, at the start of every room, and persists like the Ludovico tear itself.
  • Maw of the Void Maw of the Void
    Maw of the Void Icon.png+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.
    + Proptosis Proptosis
    Proptosis Icon.pngTears start out massive with high damage, and then shrink down and become weaker over a short range.
    - The ring deals normal damage.

Pickups[edit | edit source]

General

Hearts[edit | edit source]

Black heart
  • Has unique sounds.
Eternal heart
  • Takes half a heart worth of damage from any lethal hit taken with only soul hearts.
Gold heart
  • Turns nearby enemies to gold when breaking.
  • Added better visual feedback when breaking.
  • Minimap icon added.
  • Has unique sounds.
Half red heart
  • Minimap icon added.
Half soul heart
  • Minimap icon added.

Coins[edit | edit source]

Lucky penny
  • Has a green shine.

Bombs[edit | edit source]

Gold bomb
  • Has unique sounds.

Pills[edit | edit source]

Friends Till The End!
  • Has narration.

Cards and Runes[edit | edit source]

? Card ? Card
Q Card Icon.pngWhen used, copies the effect of Isaac's currently held activated collectible item.
  • Its card ID is 48 instead of 43.
A Card Against Humanity A Card Against Humanity
A Card Against Humanity Icon.pngCovers the entire room with poop. The process is not instant, and the room will not get filled if you leave it before it's done filling.
  • Has a unique card back.
Chaos Card Chaos Card
Chaos Card Icon.pngThrows the card to kill anything in its path. Opens normal doors.
  • Has a unique card back.
Credit Card Credit Card
Credit Card Icon.pngConverts all items in the Shop or Devil Room into pickups or items on pedestals, allowing them to be picked up for free. This card's effect lasts for the entire floor, but only affects the room it was used in. Wasted if used outside the shop or the devil room. Allows devil room items to be obtained without affecting the chance of an angel room appearing.
  • Has a unique card back.
Added in Afterbirth Get out of Jail Free Card Get out of Jail Free Card
Get out of Jail Free Card Icon.pngUpon use, opens all doors in the current room (including the golden door at The Chest / Dark Room), similar to Dad's Key.
  • Has a unique card back.
Added in Afterbirth † Holy Card Holy Card
Holy Card Icon.pngGrants the Holy Mantle effect for the current room.
  • Has a unique card back.

Chests[edit | edit source]

General
  • Items dropped no longer revert to their generic stone pedestal look upon leaving and reentering the room.
Golden chest
Spike chest

Entities[edit | edit source]

Monsters[edit | edit source]

General
  • Champion enemies no longer deal contact damage if the non-champion version doesn't.
  • Charmed enemies prioritize non charmed enemies unless there aren't any.
  • Permanently charmed enemies no longer try to go after Punching Bag.
  • Permanently charmed enemies are able to shoot projectiles through each other and familiars.
  • Monster replacements will now only occur with enemies spawned as part of the room layout.
Begotten
  • Is chained to an adjacent rock if the nearest wall is more than 1 grid cell away.
Big Spider
Blue Gaper
  • Reduced Base HP and added stage HP.
  • Has a proper appear animation if spawned by a room rather than by a boss.
Conjoined Fatty
  • Added extra sounds and effects to creep attacks.
Death's Head
  • No longer deals contact damage during its death animation.
Drowned Hive
Greed Gaper
  • Has a proper appear animation if spawned by a room rather than by a boss.
Hive
Homunculus
  • Is chained to an adjacent rock if the nearest wall is more than 1 grid cell away.
Lil Haunt
  • Is no longer considered boss.
  • Has a unique death portrait.
Lump
Meatball
  • Added extra sounds and effects to creep attacks.
Mega Clotty
  • Make a sound when stomping.
Nest
Oob
Rage Creep
  • Its brimstone is no longer moved upwards and no longer cause the player to take damage along the top wall in Womb/Utero room #202.
  • Its attack animation slightly longer.
Spider
Stone Grimace and all its variants
Stone Grimace
  • Closes its eyes when the room is cleared.
  • No longer respawn when reentering the room if killed.
Super Pooter
  • Renamed from "Fat Fly" to "Super Pooter".

Mini-Bosses[edit | edit source]

Greed
  • The Greed fight before Ultra Greed triggers the victory jingle when cleared.
Stone Grimace
  • No longer plays its appear animation if encountered in an already cleared room.
Super Greed
Swinger
  • Spawns with its head retracted and extends over 2 seconds.

Bosses[edit | edit source]

Brownie
The Cage
  • Its grey creep blinks.
The Duke of Flies
The Forsaken
  • Moves to a more appropriate place to perform his Brimstone attack in L shaped rooms.
  • Multiple Forsakens in the same room are able to spawn their own Bony each and always spin their Brimstone attack in the same direction at the same speed.
The Haunt
  • Champion variants are transparent during their first phase.
Hush
  • Due to the way entity stacking works ??? may rarely appear instead and once defeated will skip "phase 2" entirely and will give a completion mark as if Hush was defeated.
Krampus
  • Does a short dash towards the player before doing a spinning Brimstone attack.
  • Can shoot Brimstone lasers in all 4 diagonal directions.
The Lamb
  • No longer do its rotating Brimstone attack when close to a wall.
Little Horn
  • Has new champion versions:
    • Orange: Spits out an orange Troll Bomb instead of a black ball. The bomb deals contact damage and leaves a patch of fire similar to Hot Bombs.
    • Black: Does not attack with Pits or troll bombs, but fires smoke balls more frequently.
Mega Satan
  • If The Void is unlocked, there is a 50% chance that the game will not immediately end, and Mega Satan will instead drop an ending chest along with a portal. Entering the chest ends the game and plays the cutscene, while entering the portal will take Isaac to The Void.
Mom
  • Familiars are teleported to the player's position when entering the boss room.
Rag Man
  • Has new champion versions:
    • Black: Spawns 2 spiders instead of a Ragling. Uses his resurrect frequently. This won't resurrect anything since the spiders don't leave corpses, but still heals him. Sprays tears during his resurrect, similar to Monstro's spit.
    • Red: No longer fires tears. Can have up to 4 Raglings at one time. Can revive 2 Raglings at once.
Triachnid
  • Has a death animation.

Creeps[edit | edit source]

Red creep

Environment[edit | edit source]

General
  • Added some backdrop tiling fixes.
  • Pit seams are fixed.

Chapters[edit | edit source]

Womb
  • Womb trapdoors have a new sprite for when they are closed.
???
  • Additionally, an exit will spawn in the corner of the room, containing a Portal leading to The Void.
Cathedral
  • Has a new floor transition animation.
  • Some rooms contain Angel Statues that can be bombed to summon the Angels and acquire key pieces.

Rooms[edit | edit source]

Treasure Room
  • There is a chance that 2-3 Greed Gapers may appear in the room.
  • Treasure rooms can rarely contain two items that can both be taken or poop, trinket and a couple of pickups instead of an item.
  • New layouts:

Treasure Room 31.pngTreasure Room 32.pngTreasure Room 33.pngTreasure Room 34.pngTreasure Room 35.pngTreasure Room 36.pngTreasure Room 37.pngTreasure Room 38.pngTreasure Room 39.png

Shop
  • There is a 20% chance for donation machine to be replaced by restock box.
  • There is a small chance for the shop to be replaced by one of its two rare variants:

Shop 7.pngShop 6.png (the two pennies are lucky pennies)

Curse Room
  • Can contain a Devil statue and a random item, surrounded by spikes.
  • Minimap icon changed.
Sacrifice Room
  • Minimap icon changed.
  • New layout:

Sacrifice Room 10.png

Secret Room
Devil Room
  • Can contain:
  • Urns may spawn in the Devil Room.
  • An angel statue can rarely substitute the Satan statue, and can be awoken with an explosion.
    • Angels spawned in this way do not drop Key Pieces.
  • Red chests inside a Devil Room no longer teleport the player to the Devil Room.
Angel Room
  • Can contain 5 soul hearts.
  • Two angel statues can appear in the same room, allowing Isaac to fight both Uriel and Gabriel. It is possible to get both Key Pieces if Isaac awakes and fights each of them one by one; however, fighting both at once will only spawn one Key Piece corresponding to the last defeated angel.
Dice Room
  • The 1 pip room re-rolls each of Isaac's passive items into a random item from the specific item pool where it was acquired.
  • The 4 pips room rerolls item pedestals located in the shop and the library.
  • Have a small icon in the corner of the room that denotes what the effect of the room is.
I AM ERROR
Boss Rush
  • There is a small chance that there will be 8 items to choose from.
  • Using the Black Rune will start the Boss Rush.
  • New layout:

Boss Rush 6.png

Crawl Space
  • New layouts (rares):

ItemDungeon 10.pngItemDungeon 11.png

Black Market
  • Players can no longer access the Black Market through the wall glitch. However, it is still possible to access the Black Market using the glitch via special circumstances including having Ipecac and The Inner Eye.

Obstacles[edit | edit source]

Mushrooms
Normal button
  • Locks the room when spawning enemies.
Silver button
  • No longer grants a charge when bombing out of its room.
Pushable TNT
  • Takes damage exactly like their regular counterparts.
Spikes
  • No longer stay in their raised position when clearing pressure plate rooms.
  • Start (and remain) in their lowered position when entering a cleared pressure plate room.

Machines[edit | edit source]

Donation Machine
  • Donation gradually accelerates if the player stays in contact with the donation machine.
Greed machine
  • No longer jams when the HUD displays a jamming rate of 0%.
  • Donation gradually accelerates if the player stays in contact with the greed machine.
Slot machine
  • Items dropped no longer revert to their generic stone pedestal look upon leaving and reentering the room.

Challenges[edit | edit source]

  • Killing Delirium will count as completing challenges.
I RULE!

Achievements[edit | edit source]

General
  • Popups can be fast forwarded by tapping Start.

Bugs[edit | edit source]

Fixed bugs[edit | edit source]

New bugs[edit | edit source]

Bug Bug! If an angel statue is broken inside the devil room the door will incorrectly be shown to be open, but can't be escaped from
Bug Bug! Sometimes, Scolex's sprite will be replaced with that of a second form Frail, who has an upside-down tail. This is purely a visual bug and the Frail will have all of Scolex's attacks and AI, though the tail's hitbox will be slightly misplaced. This appears to only happen to black champion Scolex, and has been seen in both Hard and Greedier Mode.
Bug Bug! When Scolex is slowed, some of his body parts may detach or won't even show up - they will only be visible while entering the ground (especially the tail).

Broken Modem Icon.png Version History Broken Modem Icon.png

Removed in Afterbirth Rebirth v0.9, v1.0, v1.01, v1.02, v1.031, v1.032, v1.04, v1.041, v1.05, v1.05 Hotfix
Added in Afterbirth Afterbirth v1.06, v1.06 Hotfix, v1.06.0051, v1.06.0052, v1.06.0059, v1.06.0060, v1.06.0067, v1.06.0076, v1.06.0109
Added in Afterbirth † Afterbirth † v1.06.0180, v1.06.0181, v1.06.0182, v1.06.0183, v1.06.0185, v1.06.0187, v1.06.0188, v1.06.0190, v1.06.0192, v1.06.0192 (Re-release), v1.06.0193, v1.06.0211
Booster Pack #1 v1.06.J34, v1.06.J39
Booster Pack #2 v1.06.J75, v1.06.J85
Booster Pack #3 v1.06.J99, v1.06.J103, v1.06.J104
Booster Pack #4 v1.06.J113, v1.06.J114, v1.06.J119, V1.06.J127
Booster Pack #5 v1.06.J149, v1.06.J150, V1.06.J168


The Binding of Isaac: Rebirth The Binding of Isaac: Rebirth The Binding of Isaac: Rebirth
MainPageAchievements.png Achievements MainPageAttributes.png Attributes MainPageBosses.png Bosses TarotCard.png Cards and Runes MainPageChallenges.png Challenges MainPageChapters.png Chapters
Isaac App.png Characters MainPageBabies.png Co-op MainPageItems Small.png Items Item Pools Item Pools MainPageMonsters.png Monsters MainPageObjects.png Objects
Red heart.png Pickups BlueBlue.png Pills MainPageRooms.png Rooms MainPageSeeds2.png Seeds Guppy App.png Transformations The Left Hand Icon.png Trinkets