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The Binding of Isaac: Afterbirth †/Changes

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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 LifeBreath 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 BeanButter 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 D4D4 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 DiplopiaDiplopia 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 BallFriendly 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 GlassGlowing 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 HeadGuppy's Head Icon.png1 roomsSpawns 2-4 blue flies to damage enemies.
  • The number of flies is seeded.
Head of Krampus Head of KrampusHead 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 JarThe 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 FliesJar 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 CrafterMine 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 UnicornMy 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 BoxPandora'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 BibleSatanic 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 UndefinedUndefined 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 RazorVentricle 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 BandagesBall 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 BatteryThe 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 BetrayalBetrayal 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 CandleBlack 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 BodyThe Body Icon.pngAdds 3 heart containers.
  • Its costume has color alts.
Bogo Bombs Bogo BombsBogo Bombs Icon.pngAll standard bomb pickups become 1+1 bomb pickups.
  • Its costume has color alts.
Bursting Sack Bursting SackBursting Sack Icon.pngSpider enemies no longer target or deal contact damage to Isaac.
  • Its costume has color alts.
Cancer CancerCancer Icon.pngAdds 3 soul hearts. Grants The Wafer effect for the current room upon taking damage.
  • Its costume has color alts.
Dead Eye Dead EyeDead 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 ColiE 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 BlessingEden'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 EpiphoraEpiphora 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 FateFate Icon.pngGrants flight and one eternal heart.
  • Its costume has color alts.
Fruit Cake Fruit CakeFruit Cake Icon.pngIsaac's tears gain a random effect that changes every shot.
Gemini GeminiGemini (Item) Icon.pngSuture becomes attached to Isaac, and does touch damage to enemies within its attacking range.
  • Added extra familiar animations.
Hive Mind Hive MindHive 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 GrailHoly Grail Icon.pngGrants flight and one heart container.
  • Its costume has color alts.
Holy Mantle Holy MantleHoly 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 ConceptionImmaculate 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 1Key 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 2Key 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 StoneKidney 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 BrimstoneLil 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 HauntLil 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 PitLord of the Pit Icon.pngGrants flight and increases speed.
  • Its costume has color alts.
Lost Contact Lost ContactLost 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 BloodLusty Blood Icon.pngEach time Isaac kills an enemy, Isaac's damage increases for the current room.
  • Its costume has color alts.
Number One Number OneNumber One Icon.png+1.5 tears, -17.62 range
  • Causes Isaac to fire "tears" from the middle instead of from his eyes, and at a slightly lower height.
Ouija Board Ouija BoardOuija 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 PHDPHD 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 BankPiggy 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 PurityPurity 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 RestockRestock 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-BabyRobo-Baby Icon.pngFollows Isaac around, shooting enemies with an eye laser similar to Technology.
Rubber Cement Rubber CementRubber Cement Icon.pngTears bounce off walls, enemies, and environmental objects.
  • Tears bounce off bombs.
  • Spectral tears no longer bounce off rocks.
Sagittarius SagittariusSagittarius Icon.pngIncreases speed by +0.2 and grants piercing tears.
  • Its costume has color alts.
Scatter Bombs Scatter BombsScatter 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 RockThe 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 SaleSteam 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 BombsSticky 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 SuccubusSuccubus 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 SynthoilSynthoil 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 HandThe Left Hand Icon.pngReplaces brown chests and golden chests with red chests.
Safety Scissors Safety ScissorsSafety Scissors Icon.pngTroll bombs turn into Bomb pickups before they explode. Mega troll bombs turn into 1+1 free bombs before they explode.
Tick TickTick 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 ? CardQ Card Icon.pngWhen used, copies the effect of Isaac's currently held activated collectible item. + Glowing Hour Glass Glowing Hour GlassGlowing 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 Volt9 Volt Icon.pngReduces the charge of any Activated Items by 1. Any 1 charge items instead have timed recharges. + The Candle The CandleThe 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 CoalA Lump of Coal Icon.pngThe more distance tears travel, the more damage they will do. + Athame AthameAthame 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 CoalA Lump of Coal Icon.pngThe more distance tears travel, the more damage they will do. + Maw of the Void Maw of the VoidMaw 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 AthameAthame Icon.pngWhenever Isaac takes damage, a black ring briefly appears around Isaac, dealing damage to all nearby enemies. + Proptosis ProptosisProptosis 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 BrimstoneBrimstone 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 IpecacIpecac 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 BatteryCar Battery Icon.pngCauses Isaac's activated item to activate twice on each use. + Mine Crafter Mine CrafterMine 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 EyeCursed 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 IncubusIncubus 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 FetusEpic Fetus Icon.pngIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote. + Monstro's Lung Monstro's LungMonstro'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 IpecacIpecac Icon.pngReplaces tears with explosive and poisoning projectiles fired in an arc from the mouth. + The Ludovico Technique The Ludovico TechniqueThe 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 IpecacIpecac Icon.pngReplaces tears with explosive and poisoning projectiles fired in an arc from the mouth. + Mom's Knife Mom's KnifeMom'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 TechniqueThe 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 BabyMultidimensional 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 VoidMaw 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 ProptosisProptosis 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 ? CardQ 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 HumanityA 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 CardChaos Card Icon.pngThrows the card to kill anything in its path. Opens normal doors.
  • Has a unique card back.
Credit Card Credit CardCredit 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.
  • Has a unique card back.
Added in AfterbirthGet out of Jail Free Card Get out of Jail Free CardGet 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 CardHoly 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
Spiked 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
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.