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Contents

MechanicsEdit

HUDEdit

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 on the Missing HUD mod for Rebirth and Afterbirth.

Victory LapEdit

  • 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 Chests and Locked Chests.
    • Killing any final boss aside from The Lamb will end the game, and the run will not be continued further.

MenusEdit

OptionsEdit

Charge bars
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.

PlayerEdit

CharactersEdit

Character  
Apollyon
 
The Forgotten
  Health      
  (soul)
  Damage 3.5 (*1.00) Forgotten: 3.50 (*1.50)
Soul: 3.50 (*1.00)
  Tears +0 +0
  Shot Speed 1 1
  Range 23.75 23.75
  Speed 1.0 Forgotten: 1.00
Soul: 1.30
  Luck 0 0
  Starting Pickups None None
  Starting Item(s)   Void None

TransformationsEdit

Name Appearance Description Items
Adult  

Grants a heart container.

Bookworm  

Roughly 25% of the time, Isaac shoots an extra tear, like   20/20.

Spider Baby  

Spawns a spider familiar that applies random status effects to enemies it comes in contact with.

Stompy None

Taking damage has a chance to spawn rock waves.

Co-opEdit

Special Babies

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

ID Appearance Name Description
55   Mort Baby Spawns a blue fly, and spawns a new blue fly whenever its blue fly is destroyed.
  Defeat Mega Satan as Apollyon to unlock it. The sprite greatly resembles   Rotten Baby.
56   Apollyon Baby Spawns with two Pretty Flies.
  Earn all Hard mode completion marks as Apollyon to unlock it.
57   Bone Baby Wields a melee bone club instead of shooting tears, similarly to The Forgotten.
  Earn all Hard mode completion marks as The Forgotten to unlock it.
58   Bound Baby Is bound to Isaac, similarly to The Forgotten's soul. Shoots spectral tears.
  Defeat Mega Satan as The Forgotten to unlock it.

Normal Babies

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

ID Appearance Name Description
428   Magiccat Baby A baby that resembles the avatar of Tikara, the artist of the Isaac Tarot deck.
429   Little Horn Baby A baby that resembles Little Horn.
430   Folder Baby A baby with a folder for a head.
431   Driver Baby A baby that is driving a car.
432   Dragon Baby A baby that resembles a dragon.
433   Downwell Baby A baby that resembles the player character from Downwell.
434   Cylinder Baby A baby that is shaped like a cylinder.
435   Cup Baby A baby with a teacup for a head.
436   Cave Robot Baby A baby that resembles Quote from Cave Story.
437   Breadmeat Hoodiebread Baby A toothy baby with a slice of toast for a head that resembles Breadmeat, a member of the Isaac community.
438   Bigmouth Baby A baby with a large, wide-open mouth.
439   Afro Rainbow Baby A baby with a rainbow colored afro.
440   Afro Baby A baby with an afro.
441   TV Baby A baby with a television for a head.
442   Tooth Baby A baby with a tooth for a head.
443   Tired Baby A tired-looking baby.
444   Steroids Baby A muscular baby.
445   Soap Monster Baby A baby that resembles Balrog from Cave Story.
446   Rojen Whitefox Baby A baby that resembles a white fox. (might be a reference?)
447   Rocket Baby A baby that looks like a firework.
448   Nurf Baby A baby that resembles D.Va from Overwatch.
449   Mutated Fish Baby A baby that resembles Fish from Nuclear Throne.
450   Moth Baby A baby that resembles Moth from Creepy Castle.
451   Buttface Baby A baby with a butt for a face.
452   Flying Candle Baby A baby that looks like a candle.
453   Graven Baby A baby with long hair. (might be a reference?)
454   Gizzy Chargeshot Baby A baby that resembles Gizzy from ChargeShot.
455   Green Koopa Baby A baby that resembles a green koopa from Mario.
456   Handsome MrFrog Baby A baby that resembles Handsome Mr. Frog from the game of the same name.
457   Pumpkin Guy Baby A baby with a pumpkin for a head wearing a purple rag. Possible reference to Terraria's Pumpking.
458   Red Koopa Baby A baby that resembles a red koopa from Mario.
459   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   Saturn Baby A baby that resembles the main character from Sgt. Saturn.
461   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   Voxdog Baby A baby that resembles Vox the Dog.
463   404 Baby A baby that has the Error trinket for a head.
464   Arrowhead Baby A baby with an arrow through its head.
465   Beanie Baby A baby wearing a green beanie.
466   Blindcursed Baby A baby with the Curse of the Blind's question mark for a head.
467   Burning Baby A baby that's been burnt to a crisp.
468   Cursor Baby A baby that looks like a mouse cursor.
469   Flybaby A baby that looks like a fly.
470   Headphone Baby A baby wearing headphones.
471   Knife Baby A baby with a knife for a head.
472   Mufflerscarf Baby A baby wearing a scarf.
473   Robbermask Baby A baby wearing a stereotypical robber's ski mask.
474   Scoreboard Baby A baby with a digital number display, like those at a sporting event or on an alarm clock, for a face.
475   So Many Eyes Baby A baby with eyes all over its body.
476   Text Baby A baby made out of text characters. (ASCII art)
477   Wing Baby A baby with wings.
480   Imp Baby A baby that resembles the modded character Fiend from Devil's Harvest MOD.
481   32bit Baby A baby that resembles Isaac in a 32 bit style.
482   Adventure Baby A baby that resembles Finn the Human from Adventure Time.
483   Bubbles Baby A baby made entirely of tar.
484   Bulb Baby A baby that's very bright for his age.
485   Cool Orange Baby A baby that resembles a very cool orange with sunglasses.
486   Crazy Ghost Baby A baby that resembles Crazy Diamond from JoJo's Bizarre Adventure. (Also possibly a reference to the modded character.)
487   Cursed Pillow Baby A baby that's unfortunately pillow shaded.
488   Egg Baby A baby that resembles the modded item Greg the Egg.
489   Factory Baby A baby that resembles a strange cyborg.
490   Falling Baby A baby that resembles William Foster from Falling Down.
491   Funny Baby A baby that resembles Sans from Undertale.
492   Gamer Baby A baby that resembles an epic gamer. Inspired by a prominent member of the Binding of Isaac community.
493   Glittery Peach Baby A baby resembling an oddly British Baby Plum from Antibirth.
494   Pompadour Baby A baby that resembles Josuke from JoJo's Bizarre Adventure. (Also possibly a reference to the modded character.)
495   Head Kick Baby A baby that resembles the Facepunch Logo.
496   Horn Baby A baby that resembles the modded character Chronos.
497   Ichor Baby A baby that resembles Ichor beasts from the game Heckland.
498   Ill Baby A baby that resembles the modded boss Mahalath.
499   Lazy Baby A baby that resembles Garfield.
500   Mern Baby Mern.
501   Necro Baby A baby that resembles the Xenomorph from the Alien franchise.
502   Peeping Baby A baby that resembles the modded boss The Peeping.
503   Penance Baby A baby that resembles the modded character Sarah from Revelations.
504   Psychic Baby A baby that resembles the modded character Mei.
505   Puppet Baby A baby that resembles the costume for the modded item Pinhead from Happy Items Pack.
506   Reaper Baby A baby that resembles the modded character Samael.
507   Road Kill Baby A baby that got ran over.
508   Sausage Lover Baby A baby that resembles _Kilburn, the lead developer for Antibirth.
509   Scribble Baby A baby that resembles the modded character The Drawn.
510   Star Plant Baby A baby that resembles the main character from Germination.
511   Twitchy Baby A baby that resembles Twitch from Heckland.
512   Witch Baby A baby that resembles the modded character Endor from Alphabirth.
513   Workshop Baby A baby that references a common trope of workshop thumbnails when firing tears.
514   Hooligan Baby A baby that resembles Čeda from LeatherIceCream's "Poor 4" animations.
515   Half Spider Baby A baby that resembles Miroslav from LeatherIceCream's "Poor 4" animations.
516   Silly Baby A baby that resembles Djole from LeatherIceCream's "Poor 4" animations.
517   Master Cook Baby A baby that resembles Andre from LeatherIceCream's "Poor 4" animations.
518   Green Pepper Baby A baby that resembles one of _Kilburn's characters.
519   Baggy Cap Baby A baby that resembles one of _Kilburn's characters.
520   Stylish Baby A baby resembling the character Ren from the currently unreleased game Shenanigans: World of Illusions.


ItemsEdit

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

Activated CollectiblesEdit

Name ID Icon Quote Description
Black Hole 512
 
Nothing can escape Throws a black hole on the ground which sucks in and damages enemies.
Book of the Dead 545
 
Rise from the grave Upon use, spawns a friendly Bony or an orbital bone for each enemy killed in the current room.
Broken Shovel 550
 
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
 
Friendly fly Spawns a stationary fly familiar that fires tears at nearby enemies.
Clicker 482
 
Change Transforms Isaac into a random character and removes the last item collected.
Compost 480
 
Gain more friends! Doubles Isaac's Blue Spiders and Flies, or spawns one if Isaac has none. Turns pickups in the room into Blue Spiders or Flies.
Coupon 521
 
Allow 6 weeks for delivery Upon use, makes a random item from a Shop, Devil deal, or Black Market free.
Crooked Penny 485
 
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.
D Infinity 489
 
Reroll forever Grants a random dice item that changes each use.
D1 476
 
What will it be? Duplicates a random pickup in the room.
Dataminer 481
 
109 Displaces enemy sprites for the current room, randomly increases one stat and decreases another.
Delirious 510
 
Unleash the power! Spawns Delirium as a random friendly boss that fights for Isaac.
Dull Razor 486
 
I feel numb... Hurts Isaac without depleting health, activating any items that trigger upon taking damage.
Eden's Soul 490
 
... Spawns two item pedestals then is consumed. Begins with no charges.
Mama Mega! 483
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
 
Waggles a finger Grants a random item effect for the current room.
Mom's Shovel 552
 
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   Dark Room.
Moving Box 523
 
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
 
Caaan do! Summons a controllable ghost that can perform various tasks depending on what it targets.
Mystery Gift 515
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.
Pause 478
 
Stop! Freezes all enemies until a fire button is pressed.
Plan C 475
Use with caution Kills all enemies in the room, then kills Isaac three seconds later.
Potato Peeler 487
A pound of flesh Removes a heart container, increases damage and range, and grants a Cube of Meat.
Sacrificial Altar 536
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
 
More blood! Damages all enemies in the room. Has a chance to drop a half red heart or half soul heart if an enemy is hit.
Smelter 479
 
Trinket melter! Consumes Isaac's currently held trinket and applies its effect permanently.
Sprinkler 516
 
Sprinkles. Upon use, spawns a sprinkler that rotates and fires tears.
Telekinesis 522
 
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
 
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
 
I can't believe it's not Butter Bean! Isaac farts, sending out rock waves.

Passive CollectiblesEdit

Name ID Icon Quote Description
7 Seals 526   Lil harbingers! Grants a random Harbinger familiar that changes every 10 seconds. Harbingers have different behaviors and spawn themed Locusts.
Acid Baby 491   Pills pills pills! Spawns a familiar that drops random pills every 3 rooms cleared. Upon using a pill, all enemies in the room are poisoned.
Adrenaline 493   Panic = power Increases damage based on how many empty Red Heart containers Isaac has.
Analog Stick 465   360 tears! +0.3 tears up. Allows Isaac to fire tears diagonally.
Angelic Prism 528   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   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   Trick or treat? Increases tears. Adds a chance to fire a high-damage razor blade.
Backstabber 506   Watch your back! Isaac's tears deal double damage and inflict bleeding on enemies if they're facing away from Isaac.
Belly Button 458   What's in there? Drops a random trinket. Grants a second trinket slot.
Big Chubby 473   Chub chub Spawns a fat charger familiar that slowly charges forward, blocking shots and damaging enemies in its path.
Blanket 535   You feel Safe Grants one Soul Heart. Upon entering a boss room, grants a shield that blocks one hit, then disappears.
Bloodshot Eye 509   Bloody friend Spawns an orbiting eye familiar that deals contact damage and fires tears every 2 seconds.
Bozo 513   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   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   Lag! Enemies, enemy shots, tears, and pickups will briefly freeze in place at random intervals.
Broken Shovel 551   It feels cursed One of two parts necessary to create Mom's Shovel.
Buddy in a Box 518   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 kid Isaac becomes camouflaged at the beginning of each room. Until he shoots, all non-boss enemies will be confused.
Compound Fracture 453   Bone tears! Increases range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle.
Cone Head 457   Hard headed! Grants a Soul Heart. Gives Isaac a chance to ignore any damage taken.
Contagion 466   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   I remember this... Increases range by 1.5. Drops a Lucky Penny.
Dad's Ring 546   Father's blessing Creates a ring of light around Isaac that petrifies enemies in contact.
Dark Prince's Crown 442   Loss is power Increases range, tears, and shot speed when at exactly one red heart.
Dead Tooth 446   Halitosis While firing, Isaac gains a green aura that poisons nearby enemies.
Death's List 530   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   :( 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   Tears up + you feel empty Spawns a Mysterious Paper, increases tears, and grants a bone heart.
Dog Tooth 445   Bark at the moon! +0.3 damage and +0.1 speed. When Isaac enters a room, a howling sound can be heard if there's a connected secret room, and a barking sound can be heard if there's a crawl space under a rock.
Duality 498   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   Peace be with you An Angel Room door will always spawn after every boss fight, excluding the first floor and floors after   The Womb II/  Utero II.
Euthanasia 496   Needle shot Adds a chance to fire needles that instantly kill basic enemies and deal triple damage to bosses. If a needle kills an enemy, it bursts into more tears/needles.
Eye of Belial 462   Possessed tears! Grants piercing tears. After piercing one enemy, tears start homing and deal double damage.
Eye of Greed 450   Gold tears! Every 20 tears, Isaac loses 1 penny and shoots an additional gold tear that freezes enemies and turns them into gold. Any enemy killed while in this state will drop coins.
Fast Bombs 517   Rapid bomb drops Grants 7 bombs and allows bombs to be placed rapidly.
Finger! 467   Watch where you point that! Spawns a finger familiar that points at enemies, dealing constant damage.
Flat Stone 540   Skipping tears Tears bounce off the floor, creating splashes. Splashes deal 25% of Isaac's tear damage to all enemies in a small area.
Ghost Pepper 495   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   Blind tears! Adds a chance to shoot tears that confuse enemies for an extremely long time.
Glyph of Balance 464   A gift from above Grants 2 Soul Hearts and modifies drops from Champion monsters based on certain conditions.
Greed's Gullet 501   Money = health! Grants a Red Heart container for every 25 coins Isaac has.
Haemolacria 531   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   Portable sanctuary Spawns a white poop familiar, which turns into a white poop when Isaac is hurt. White poop has an aura that halves tear delay and can block enemy shots.
Hushy 470   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   Electric tears Tears fire sparks of electricity in random directions upon hitting an obstacle or enemy.
Jaw Bone 548   Fetch! Spawns a familiar that flies the room while firing, dealing a flat 7 damage to enemies that come in contact and retrieving pickups.
Jumper Cables 520   Bloody recharge Grants an active item charge every 15 enemies killed.
King Baby 472   Lord of the dead! Spawns a familiar that follows Isaac and makes other familiars follow it. While firing tears, it stops moving.
Lachryphagy 532   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   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   He's a bleeder! After every 15 tears fired, Isaac will fire a high-damage cluster of tears.
Leprosy 525   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   Delirious friend Grants a familiar that transforms into another random familiar every 10 seconds.
Lil Monstro 471   Ain't he cute? Spawns a familiar that fires clusters of tears. Must be charged before shooting.
Lil Spewer 537   Puking buddy Spawns a random pill, and grants a small Spewer familiar that charges up and fires creep. Using pills changes the creep type.
Linger Bean 447   Crying makes me toot Constantly shooting causes Isaac to release gas clouds that can be pushed by his tears and damage nearby enemies.
Little Horn 503   Science! Adds a chance to fire a piercing tear that instantly kills any enemy that it touches.
Marbles 538   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   HP up? Grants one bone heart and spawns three red heart pickups.
Metal Plate 449   It itches... Grants one soul heart. Enemy shots have a chance to be reflected at the shooter as confusing tears.
Moldy Bread 456   Midnight snack! Grants one full red heart container.
Mom's Razor 508   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   Sacrificial insemination Spawns an egg familiar, which cracks and turns into a random friendly enemy when Isaac is hurt. The egg regenerates upon entering a different room.
Parasitoid 461   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   Stabbing time Spawns a bone familiar that can be aimed with the fire buttons and does contact damage.
Poke Go 505   Gotta catch em... Upon entering a room with enemies in it, has a chance to spawn a random friendly enemy that persists across rooms.
Polydactyly 454   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   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   Gives sacks Spawns a sack familiar that drops a sack every 5-6 rooms cleared.
Schoolbag 534   Extra active item room Allows Isaac to hold two active items.
Shade 468   It follows Spawns a shadow familiar that follows Isaac's movements on a 1 second delay and deals contact damage to enemies. After dealing enough damage, it is absorbed by Isaac and spawns friendly Chargers.
Shard of Glass 448   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   Booger tears! Adds a chance to fire a booger that sticks to enemies and deals damage over time.
Slipped Rib 542   Projectile shield Spawns a bone familiar that circles around Isaac and reflects enemy shots.
Sulfuric Acid 463   Acid tears! +0.3 damage. Adds a chance to fire acidic tears which can destroy obstacles.
Tarot Cloth 451   I see the future Drops a random card or rune. Doubles the effects of cards and runes.
Technology Zero 524   Static tears! Connects Isaac's tears with electricity that can damage enemies.
Tonsil 474   Gross... Grants a familiar that can block enemy shots.
Trisagion 533   Smite thy enemy Damage down. Tears are replaced with piercing white blasts of light that can damage the same enemy multiple times.
Varicose Veins 452   I'm leaking... Taking damage releases a ring of 10 high damage tears.
YO LISTEN! 492   Yo listen! +1 luck. Spawns a fairy familiar that points out secret room entrances and tinted rocks.

TrinketsEdit

38 new trinkets were added in the expansion.

Name ID Icon Quote Description
Baby-Bender 127   Feed them magic! Grants Isaac's familiars homing shots.
Bag Lunch 105   I wonder what it is Taking damage has a small chance to destroy the trinket and spawn   Lunch.
Bat Wing 118   They are growing... Upon killing an enemy, has a chance to grant flight for the rest of the room.
Black Tooth 95   It looks dead Adds a chance to fire a black tooth that deals double damage and poisons enemies.
Bloody Crown 111   Drips with blood... Treasure Rooms appear in chapter 4.
Butter! 122   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.
Cracked Crown 92   Stat booster Decreases Isaac's tear delay by 20%, and improves the effectiveness of his other stat upgrades by ~33%.
Crow Heart 107   Drain me Red Heart damage will be taken before Soul and Black Heart damage.
Dim Bulb 101   I think it's broken Provides a boost to all stats when Isaac's active item is completely uncharged.
Door Stop 124   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   Stuck! Stops Isaac's familiars from moving.
Equality! 103   = Turns pickups into their doubled versions while Isaac's numbers of coins, bombs, and keys are equal.
Extension Cord 125   Charged friends Beams of yellow electricity flow between Isaac and his familiars, damaging any enemies between them.
Filigree Feather 123   Angelic Spoils! Angels drop Angel Room items instead of key pieces when defeated.
Finger Bone 128   It looks brittle Grants a chance to gain a bone heart upon taking damage.
Fish Tail 94   It also stinks! Items and trinkets that generate Blue Flies or Blue Spiders will generate twice as many.
Fragmented Card 102   Double moon Makes two Secret Rooms spawn on each floor.
Hairpin 120   Danger charge Fully recharges Isaac's active item upon entering a boss fight.
Locust of Conquest 117   I bring Conquest Upon entering a room with enemies, spawns 2-5 White Locusts which damage enemies.
Locust of Death 116   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   I bring Famine Upon entering a room with enemies, spawns a Yellow Locust that damages and slows enemies.
Locust of Pestilence 114   I bring Pestilence Upon entering a room with enemies, spawns a Green Locust which damages and poisons enemies.
Locust of War 113   I bring War Upon entering a room with enemies, spawns a Red Locust which detonates upon impact with enemies.
Lost Cork 106   Uncorked Increases the radius of any creep produced by Isaac.
Meconium 91   Eww Black poop can drop black hearts when destroyed. Poop has a chance to turn into black poop.
Nose Goblin 98   Seems magic... Chance to fire a homing booger that sticks to enemies and deals damage over time.
Ouroboros Worm 96   Foop foop! Tears travel in a large spiral pattern and become spectral, with a small chance to home.
Pay to Win 112   ... Restock boxes always spawn in Item Rooms.
Rotten Penny 126   Wealth of flies Spawns a blue fly every time a coin is picked up.
Silver Dollar 110   Feels lucky... Shops appear in Chapter 4.
Stem Cell 119   Regen! Heals Isaac for half a heart upon traveling to the next floor.
Super Ball 99   Boing! Makes tears have a chance to bounce off enemies and obstacles.
Tonsil 97   Sick... When hit, there is a small chance a removed tonsil familiar starts following Isaac, blocking enemy shots.
Used Diaper 93   You stink Grants the Skatole effect in some rooms.
Vibrant Bulb 100   It needs power Provides a boost to all stats when Isaac's active item is fully charged.
Walnut 108   That's a hard nut to crack! Being hit by explosions will eventually destroy the trinket and spawn various pickups.
Wish Bone 104   Make a wish Taking damage has a small chance to destroy the trinket and spawn a random item.
Wooden Cross 121   My faith protects me Grants a shield that negates the first damage taken once per floor.

PickupsEdit

HeartsEdit

Heart ID Image Worth Additional Info Unlocked By
Scared Heart 9     Identical to the standard Red Heart, but will run away as the player moves towards it.
Heals    with   Maggy's Bow.
  Humbling Bundle and   Equality! will not double this.
Half Soul Heart 8       Reset 7 times in a row

 Switch   PS4  Get a minus 10-win streak

Blended Heart 10    / /   Fills up a full red Heart Container, but will act as a Soul Heart when no Containers are free. If Isaac is only missing half a Red Heart, it will fill that half, and give him half a soul heart as well.
  Dark Bum and   The Jar will not collect this.
Bone Heart 11     Takes three hits to deplete and can be refilled with red hearts, but disappears permanently upon depleting.   It's complicated

KeysEdit

Key ID Image Worth Additional Info Unlocked By
Charged Key 4   1 Fully charges your currently held active item upon pickup.
Key Bum will pick this up, but will not give Isaac any active charge.
  Complete Pokey Mans (challenge #33)

PillsEdit

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   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   Horf!

Upon use, Isaac shoots an explosive tear with the   Ipecac effect that always deals 200 damage.
Unlocked by acquiring the Dedication achievement.

45   Feels like I'm walking on sunshine!

Temporarily makes Isaac invincible, similar to   Unicorn Stump.
Unlocked by acquiring the Sin Collector achievement.

46   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.

CardsEdit

Name ID Icon Message Effect
Ace of Clubs 27   Convert all Turns all pickups and chests in the room into Bombs.
Ace of Diamonds 28   Convert all Turns all pickups and chests in the room into Pennies.
Ace of Hearts 30   Convert all Turns all pickups and chests in the room into random heart pickups.
Ace of Spades 29   Convert all Turns all pickups and chests in the room into Keys.
Ancient Recall 53   Draw 3 cards Spawns 3 random cards.
Era Walk 54   Savor the moment For the current room, enemies are slowed, Isaac's speed is increased, and his shot speed is decreased.
Holy Card 51   You feel protected Grants the   Holy Mantle effect for the current room.
Huge Growth 52   Become immense! Makes Isaac large for the current room, increasing his range and damage.

RunesEdit

Rune ID Icon Unlock method Message Effect
Black Rune 41   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. No effect on shop items.

ChestsEdit

  Mimic Chests
  • Mimic Chests 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.

EntitiesEdit

MonstersEdit

Monster Description
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.
Mr. Red Maw
 
Walks towards Isaac and attacks by launching its head towards him. Turns into a Red Maw or Gusher upon death depending on the killed body segment. Occasionally separates at will.
Soul Sucker
 
Flies slowly towards Isaac. Spawns a vortex that fires four Brimstone beams in the cardinal directions upon death.
Cross Stone Shooter
 
Stationary and invulnerable monster that continuously fires shots in four directions, alternating between cardinal and ordinal.
Crispy
 
Slowly walks towards Isaac, but increases in speed as they take damage. Constantly passively takes damage.
Nerve Ending 2
 
Static enemy which whips at Isaac if he gets too close.
Tube Worm
 
Pops out of the ground in random locations and fires a long-range spray of arcing shots.
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.
Poison Mind
 
Slowly crawls around the room diagonally, leaving a trail of Green Creep.
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.
Cross Stoney
 
Chases Isaac and shoots 4 tears vertically and diagonally like a Cross Grimace. Dies when the room is cleared.
Only appears in Aprils Fool (challenge #32) as replacements to regular Stoneys.
Blister
 
Slowly hops towards Isaac, occasionally spawning a Dark Ball. Spawns a Sack upon death.
The Thing
 
Crawls along a wall and attempts to line up with Isaac, then spits a line of damaging Red Creep.
Ministro
 
Hops towards Isaac, occasionally spitting out a cluster of disorganized shots.
Portal
 
Spawns various enemies from the current floor until it either vanishes or is killed.
Tar Boy
 
Fires a short-ranged spray of shots that leave behind slowing Black Creep. Occasionally burrows underground and reappears under any pools of black creep in the room. If Isaac stands on the Creep, the Tar Boy can fire shots straight upwards out of the Creep underneath Isaac.
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
 
Stationary, harmless enemy that continually creates slowing black creep.
Leper
 
Walks around the room, chasing Isaac but running way if they take damage. Releases a Leper Flesh for every 15 damage taken. After being reduced to 15 health, chases Isaac continously and leaves damaging Red Creep. Spawns a Leper Flesh and a Grey-coloured Gusher upon death.
Leper Flesh
 
Moves erratically and chases Isaac. Fires a blood shot at Isaac upon death.
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.
Purple Ball
 
Floats towards Isaac, doing contact damage.

BossesEdit

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

 
Rag Mega Big Horn Sisters Vis The Matriarch
Delirium Ultra Greedier

EnvironmentEdit

ChaptersEdit

 
The Void

ObstaclesEdit

  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.
  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 item while Isaac stands within it. The aura disappears if the poop is destroyed.
   Dirt patch
  • Dirt Patches are a small mound of dirt that can be dug into with certain items. Using   Mom's Shovel 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!, or   Ehwaz on top of a dirt patch will dig up a random chest.

MachinesEdit

  Mom's Dressing Table

ChallengesEdit

Name Conditions Goal Unlocked by Unlocks


AchievementsEdit

Name Image Description Unlock In Game Secret Number Platforms


1000000%   Just Stop! Collect every item in the game, unlock all secrets and endings, and complete the bestiary (minus anything added in Booster Packs; as of Booster Pack #5, all achievements from Booster Packs, as well as the renewed bestiary, need to completed) 339
5 Nights at Mom's   Unlocked super special rocks. Get a 5-win streak, using a different character for each win 323
7 Seals   Unlocked a new item. Defeat all 5 Harbingers 372
Ancient Recall   Unlocked a new item. Use cards and runes 20 times 362
Angelic Prism   Unlocked a new item. Defeat an Angel 10 times 373
Angry Fly   Unlocked a new item. Become Beelzebub 352
Apollyon   Unlocked a new character. Defeat Mega Satan 340
Apollyon Baby   Unlocked a new co-player baby. Earn all Hard mode completion marks as Apollyon 319
Aprils fool   Unlocked a new challenge. Defeat Mom 278
Baby-Bender   Unlocked a new item. Use   I - The Magician or   Telepathy for Dummies while already having homing tears 389
Backasswards   Unlocked a new challenge. Defeat ??? or The Lamb 277
Bat Wing   Unlocked a new item. Defeat Ultra Greedier as Azazel 304
Black Hole   Unlocked a new item. Defeat 20 portals 349
Black Rune   Unlocked a new item. Defeat Ultra Greedier as Apollyon 309
Blanket   Unlocked a new item. Sleep in 10 beds 385
Bloody Crown   Unlocked a new item. Defeat Delirium as Samson 287
Bone Baby   Unlocked a new co-player baby. Earn all Hard mode completion marks as The Forgotten 402
Bone Heart   Unlocked a new item. It's complicated 391
Book of the Dead   Unlocked a new item. Defeat Delirium as The Forgotten 401
Bound Baby   Unlocked a new co-player baby. Defeat Mega Satan as The Forgotten 403
Bozo   Unlocked a new item. Destroy 5 rainbow poops 353
Brittle Bones   Unlocked a new item. Defeat The Lamb as The Forgotten 396
Broken Modem   Unlocked a new item. Complete 7 (30 on console, 7 on  Switch ) daily challenges (by touching the trophy at the end) 354
Brown Nugget   Unlocked a new item. Defeat Ultra Greed as Apollyon 316
Buddy in a Box   Unlocked a new item. Pick up 5 familiars in a single run 355
Burning Basement   Alt stage to the basement. Defeat Mom's Heart 11 times 342
Butter!   Unlocked a new item. Complete 2 Victory Laps and start a 3rd 360
Charged Key   Unlocked a new item. Complete Pokey Mans (challenge #33) 333
Compound Fracture   Unlocked a new item. Defeat Delirium as Lazarus 291
Coupon   Unlocked a new item. Purchase from Shops, Devil deals or Black Markets 50 times 364
Crooked Penny   Unlocked a new item. Defeat Delirium as Keeper 294
Crow Heart   Unlocked a new item. Defeat Ultra Greedier as Eve 302
D Infinity   Unlocked a new item. Defeat Delirium as Isaac 282
D1   Unlocked a new item. Defeat Ultra Greedier as Isaac 296
Dad's Lost Coin   Unlocked a new item. Defeat Ultra Greedier as The Lost 307
Dad's Ring   Unlocked a new item. Defeat Ultra Greedier as The Forgotten 400
Dank Depths   Alt stage to the depths. Defeat It Lives 21 times 344
Dark Prince's Crown   Unlocked a new item. Defeat Delirium as Azazel 290
Death's List   Unlocked a new item. Take 25 Devil deals 376
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
Delirious   Unlocked a new item. Defeat Delirium 338
Divorce Papers   Unlocked a new item. Complete the Boss Rush as The Forgotten 397
Door Stop   Unlocked a new item. Blow up doors and Secret Room walls 50 times 375
Duality   Unlocked a new item. Defeat Ultra Greedier as Lilith 306
Dull Razor   Unlocked a new item. Defeat Delirium as Eve 288
Eden's Soul   Unlocked a new item. Defeat Delirium as Eden 289
Era Walk   Unlocked a new item. Have both the   Broken Watch and the   Stop Watch in your collection 363
Eucharist   Unlocked a new item. Defeat Delirium as Magdalene 283
Euthanasia   Unlocked a new item. Defeat Delirium as Lilith 292
Extension Cord   Unlocked a new item. Have   The Battery,   9 Volt, and    Car Battery in your collection 381
Eye of Belial   Unlocked a new item. Defeat Ultra Greedier as Judas 299
Eye of Greed   Unlocked a new item. Defeat Ultra Greedier as Keeper 308
Fast Bombs   Unlocked a new item. Defeat Little Horn 20 times 356
Filigree Feather   Unlocked a new item. Acquire both key pieces 370
Finger Bone   Unlocked a new item. Defeat Ultra Greed as The Forgotten 399
Flat Stone   Unlocked a new item. Acquire   Rubber Cement 5 times 382
Flooded Caves   Alt stage to the caves. Defeat It Lives 16 times 343
Glyph of Balance   Unlocked a new item. Defeat Ultra Greedier as Magdalene 297
Greed's Gullet   Unlocked a new item. Complete Pong (challenge #35) 335
Greedier!   New mode unlocked! Donate 500 coins to the Greed Donation Machine 341
Haemolacria   Unlocked a new item. Acquire   Blood Clot 10 times 377
Hairpin   Unlocked a new item. Recharge using Lil' Batteries 20 times 358
Hallowed Ground   Unlocked a new item. Defeat Hush as The Forgotten 398
Hat trick!   Unlocked a new item. Get a 3-win streak 322
Holy Card   Unlocked a new item. Defeat Delirium as The Lost 293
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
Hushy   Unlocked a new item. Defeat Hush as Apollyon 315
It's the Key   Unlocked a new item. Defeat The Lamb without taking hearts, coins, and bombs through an entire run 327
Jaw Bone   Unlocked a new item. Defeat ??? as The Forgotten 395
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
King Baby   Unlocked a new co-player baby. Defeat Delirium as ??? 286
Lachryphagy   Unlocked a new item. Collect 10 "tears up" items or pills in one run 378
Laz Bleeds More!   Unlocked a new starting item. Complete Backasswards (challenge #31) 331
Leprosy   Unlocked a new item. Beat chapter 3 without taking damage 368
Lil Delirium   Unlocked a new item. Defeat Delirium for the 1st time 357
Lil Spewer   Unlocked a new item. Die to your own explosion from   Ipecac,   Bob's Rotten Head, or Horf! pill 384
Living on the edge   Unlocked a new item. Complete a floor after The Basement I, start-to-finish, with only half a heart of health (can use The Lost) 329
Locust of Conquest   Unlocked a new item. Complete the Boss Rush as Apollyon 314
Locust of Death   Unlocked a new item. Defeat The Lamb as Apollyon 313
Locust of Famine   Unlocked a new item. Defeat ??? as Apollyon 312
Locust of Pestilence   Unlocked a new item. Defeat Satan as Apollyon 311
Locust of Wrath   Unlocked a new item. Defeat Isaac as Apollyon 310
Maggy Now Holds a Pill!   Unlocked a new starting item. Complete Aprils Fool (challenge #32) 332
Marbles   Unlocked a new item. Use 5 Gulp! pills in one run 386
Marrow   Unlocked a new item. Defeat Mom's Heart or It Lives! on Hard mode as The Forgotten 392
Meconium   Unlocked a new item. Defeat Ultra Greedier as ??? 300
Metronome   Unlocked a new item. Defeat Ultra Greedier as Eden 303
Mort Baby   Unlocked a new co-player baby. Defeat Mega Satan as Apollyon 317
Moving Box   Unlocked a new item. Use   Pandora's Box in   Dark Room 366
Mr. ME!   Unlocked a new item. Open 20 Locked Chests 371
Mr. Resetter!   Unlocked a new item. Reset 7 times in a row

 Switch   PS4  Get a minus 10-win streak

328
Mystery Egg   Unlocked a new item. Spawn three charmed enemies in the same room 387
Mystery Gift   Unlocked a new item. Destroy 500 rocks 350
New Area   Unlocked a new area. Defeat Hush 320
Once More with Feeling!   Unlocked a new item. Complete a Victory Lap, defeating The Lamb 321
Plan C   Unlocked a new item. Defeat Ultra Greedier as Lazarus 305
Pointy Rib   Unlocked a new item. Defeat Satan as The Forgotten 394
Pokey Mans   Unlocked a new challenge. Defeat Mom's Heart 11 times 279
PONG   Unlocked a new challenge. Defeat Isaac 5 times 281
Pop!   Unlocked a new item. Beat chapter 4 without taking damage 374
RERUN   Unlocked the power of RERUN. Complete 3 Victory Laps and start a 4th 337
Rotten Penny   Unlocked a new item. Have 20 Blue Flies at the same time 388
Sack of Sacks   Unlocked a new item. Defeat Ultra Greedier as Cain 298
Sacrificial Altar   Unlocked a new item. Take 50 Devil deals 383
Samson Feels Healthy!   Unlocked a new starting item. Complete Ultra Hard (challenge #34) 334
Scarred Womb   Alt stage to the womb. Defeat It Lives 30 times 345
Schoolbag   Unlocked a new item. Enter every Shop from chapter 1 through chapter 3 in one run 379
Shade   Unlocked a new item. Defeat Delirium as Judas 285
Silver Dollar   Unlocked a new item. Defeat Delirium as Cain 284
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
Slipped Rib   Unlocked a new item. Defeat Isaac as The Forgotten 393
Smelter   Unlocked a new item. Defeat Mom's Heart or It Lives! on Hard mode as Apollyon 318
Something wicked this way comes!   Unlocked new bosses! Defeat ??? as 3 different characters 346
Something wicked this way comes+!   Unlocked even more bosses! Defeat ??? as 6 different characters 347
Sprinkler   Unlocked a new item. Beat chapter 1 without taking damage 351
Stem Cell   Unlocked a new item. Defeat Ultra Greedier as Samson 301
Technology Zero   Unlocked a new item. Pick up two technology items in one run 369
Telekinesis   Unlocked a new item. Beat chapter 2 without taking damage 365
The Forgotten   Unlocked a new character. It's complicated 390
The gate is open!   Unlocked new enemies! Defeat The Lamb 348
The Marathon   Unlocked a new item. Get a 5-win streak in the daily challenges 336
Trisagion   Unlocked a new item. Take 25 items from Angel Rooms 380
U Broke It!   Unlocked a new item. Obtain 50 items on a run (e.g., via two   Steam Sale and    Restock - Duplicate passives/familiars count towards the total, e.g., multiple   Breakfast) 330
Ultra Hard   Unlocked a new challenge. Defeat ??? or The Lamb. Possession of   The Polaroid/  The Negative is required, prohibiting getting to   Dark Room through a Sacrifice Room. 280
Void   Unlocked a new item. Defeat Delirium as Apollyon 295
Wooden Cross   Unlocked a new item. Sleep in a bed 359
ZIP!   Unlocked a new item. Defeat The Lamb in under 20 minutes 326