Treasure Room (Greed Mode Item Pool)

Item Pool

Treasure Room

Shop

Library

Curse Room

Boss

Secret Room

Devil Room

Angel Room

Golden Chest

Red Chest

Beggar

Devil Beggar

Key Master

Bomb Bum

Treasure Room

Shop

Library

Curse Room

Boss

Secret Room

Devil Room

Angel Room

Golden Chest

All of the items in this pool can be found in the gold Treasure Room in Greed Mode. They can also occasionally be found in the Greed Mode Shop.

Activated Collectibles

Name	ID	Icon	Quote	Description
Anarchist Cookbook	65		Summon bombs	Spawns six Troll Bombs around the room.
The Bean	111		Toot on command	Isaac releases bad gas, poisoning any enemy in close vicinity.
Blood Rights	186		Mass enemy damage at a cost	Isaac takes one full red heart of damage and damages all enemies in the room.
Bob's Rotten Head	42		Reusable ranged bomb	Upon use, Isaac holds a poison bomb which can be thrown towards any of the four cardinal points and explodes on impact.
The Book of Belial	34		Temporary DMG up	Increases damage by 2 for the current room, also granting a 1.5x damage multiplier if Isaac has Blood of the Martyr. Guarantees a Devil Room or Angel Room will be open after beating a boss while holding it. Increases the chance by 12.5%.
The Book of Sin	97		Reusable Item Generator	Spawns a random pickup, pill, card, or trinket.
Book of Revelations	78		Reusable soul protection	Adds 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).
Box of Friends	357		Double your friends	Upon use, duplicates all of Isaac's familiars for the current room.
Box of Spiders	288		It's a box of spiders	Summons 2-4 Blue Spiders.
Dad's Key	175		Opens all doors...	Opens all doors in the current room when activated, including doors which require a key to open and entrances to Secret Rooms. Opens the big doors in the first room of both The Chest and the Dark Room.
Dead Sea Scrolls	124		It's a mystery	Triggers the effect of a random activated item from a list of possible options (not every activated item is included).
Deck of Cards	85		Reusable card generator	Gives Isaac a random tarot card.
Doctor's Remote	47		Reusable Air Strike	Creates a crosshair on the ground that can be aimed with tear controls. A missile strikes the spot after 2 seconds, dealing heavy damage.
Flush!	291		...	Changes all enemies in the room into poop. Does not work on all enemies (Knights and bosses are immune). Instantly kills Dingle, Dangle, Brownie, and other poop-themed enemies.
Friendly Ball	382		Gotta fetch 'em all!	Throwing the ball at an enemy instantly kills it and captures it. The captured enemy can later be released and will be friendly, fighting for Isaac and persisting between rooms.
The Gamekid	93		Temporary Man-Pac	Upon use, turns the character into a into a Pac-Man-like creature for 5 seconds, granting invulnerability, inflicting fear on all enemies, and replenishing half a red heart container for every two enemies killed.
Glass Cannon	352		Be gentle...	Reduces Isaac's health to half a heart (including Soul and Black Hearts) and fires a large piercing spectral tear that does very high damage.
Jar of Flies	434		Gotta catch 'em all?	Every time Isaac kills an enemy, a fly will be added to the jar, up to a maximum of 20. Using the Jar of Flies will release all the flies that are currently in the jar as friendly blue flies that will damage enemies.
Kidney Bean	421		Love toots!	Upon use, Isaac farts, charming all nearby enemies.
Lemon Mishap	56		Oops...	Creates a small yellow pool of creep, which damages enemies that cross it.
Mega Bean	351		Giga fart!	Freezes all enemies in the current room for a couple of seconds, poisons any enemies near Isaac, and sends a rock wave across the room in the direction Isaac is facing.
Mom's Bottle of Pills	102		Reusable pill generator	Gives Isaac a random pill, and will cause him to drop any held Q-slot item (If any). The player will only receive six different pill types in one playthrough.
Mr. Boom	37		Reusable bomb buddy	Drops a large bomb.
My Little Unicorn	77		Temporary badass	Upon 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.
The Necronomicon	35		Mass room damage	Damages all enemies in the room significantly.
The Pinking Shears	107		Cut and Run	Separates Isaac's head and body for the current room. Isaac's head, which now has flight, will be under the player's control, while his body will seek out enemies to attack by contact damage.
Prayer Card	146		Reusable eternity	Grants an eternal heart per use.
Remote Detonator	137		Remote bomb detonation	Bombs placed by Isaac only explode when Remote Detonator is used. Gives 5 bombs.
Scissors	325		Lose your head	Upon use, turns Isaac's head into a stationary familiar for the current room which fires normal tears that deal 3.5 damage.
Tammy's Head	38		Reusable tear burst	Shoots 10 tears in a circle around Isaac, which retain the damage, shot speed, and special effects (such as poison) of Isaac's tears.
Tear Detonator	383		Remote tear detonation!	When used, will detonate any tears currently on the screen and cause each one to split into 6 more tears which will fire in a circle, similar to Tammy's Head.
Telepathy for Dummies	192		Temporary psychic shot	Upon activation, grants homing tears for the current room.
Wooden Nickel	349		Flip a coin	When used, has a 50% chance to drop one random type of coin (Penny, Nickel, or Dime).
Yum Heart	45		Reusable Regeneration	Restores 1 whole red heart.
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.
Brown Nugget	504		Friendly fly	Spawns a stationary fly familiar that fires tears at nearby enemies.
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.
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.
Wait What?	484		I can't believe it's not Butter Bean!	Isaac farts, sending out rock waves.

Passive Collectibles

Name	ID	Icon	Quote	Description
20/20	245		Double shot	Isaac fires two tears at once, one from each eye.
3 Dollar Bill	191		Rainbow tears	Gives Isaac a random tear effect every room. Gives Isaac a random tear effect every few seconds.
8 Inch Nails	359		Stick it to 'em!	+1.5 Damage Up. Replaces Isaac's tears with nails, which have increased knockback.
???'s Only Friend	320		Controlled friend	Summons a big attack fly that can be controlled with the shooting direction-keys.
A Lump of Coal	132		My Xmas Present	The more distance tears travel, the more damage they will do.
Abel	188		Mirrored buddy	A familiar that mirrors the player's movements and shoots in the opposite direction.
Anemic	214		Toxic blood	+5 range. After Isaac is damaged, a trail of red creep will be left behind Isaac until he leaves the current room.
Ankh	161		Eternal life?	Upon death, the player will respawn as ??? with 3 Soul Hearts.
Anti-Gravity	222		Antigravity tears + tears up	-2 Tear Delay. Tears float in position until firing ceases, after which they will fly off in the direction they were shot in.
Aquarius	308		Trail of tears	A trail of blue creep is left behind Isaac, which damages enemies.
Aries	300		Ramming speed	+0.25 Speed. Running into enemies while at a high speed will deal 18 points of damage. Does not prevent contact damage.
Ball of Tar	231		Sticky feet...	Adds a chance to shoot slowing tears and the character leaves a trail of slowing creep behind as he moves, impeding enemies' speed.
Best Bud	274		Sworn protector	When hit, summons a white attack fly similar to Distant Admiration for the current room.
Betrayal	391		Turn your enemy	Every time Isaac takes damage, a charm effect is applied to every enemy in the room, causing them to attack each other rather than Isaac.
Big Fan	279		Fat protector	Spawns a large orbital familiar that blocks enemy projectiles and deals slight contact damage to enemies.
Black Lotus	226		HP up x3!	Grants the player one Red Heart container, one Soul Heart, and one Black Heart.
Blood Clot	254		DMG + range up	Increases damage by 1 and range by 5 for tears fired from the left eye.
Blood of the Martyr	7		DMG up	Increases Damage by 1, and turns Isaac's tears into blood tears.
Bloody Lust	157		RAGE!	Increases damage as Isaac receives damage. Damage increase stays for the whole floor.
Bob's Brain	273		Explosive thoughts	Spawns a familiar that charges forward when shooting tears and explodes upon contact with an enemy, damaging and poisoning them. The familiar respawns after a few seconds.
Bob's Curse	140		+5 poison bombs	Gives 5 bombs and grants all bombs poison effect.
Bobby-Bomb	125		Homing bombs!	Gives Isaac 5 Bombs and causes all dropped bombs to home towards the closest enemy.
The Body	334		I feel all	Adds 3 Heart Containers.
Bomb Bag	131		Gives bombs	Isaac is followed by a small bag that drops a Bomb, a Double Bomb, a Troll Bomb, or a Golden Bomb every 3 rooms.
Bomber Boy	353		Explosive blast!	+5 bombs. Isaac's bombs will now explode in a large cross-shaped pattern (roughly 5 bombs explosions wide). This also affects player-spawned Troll Bombs.
Brother Bobby	8		Friends 'till the end	Follows Isaac around shooting normal tears.
Bursting Sack	377		Spider love	Spider enemies no longer target or deal contact damage to Isaac.
Butt Bombs	209		Toxic blast +5 bombs	+5 bombs. Bombs now cloud up the screen, briefly damaging and confusing all enemies.
Cain's Other Eye	319		Near-sighted friend	Spawns a familiar that floats slowly around the room on a zig-zag pattern similar to The Peeper and shoots normal tears in the same direction as Isaac.
Cancer	301		HP up + you feel protected	Adds 3 Soul Hearts. Grants The Wafer effect for the current room upon taking damage.
Capricorn	307		All stats up	Increases health, damage, speed, and range, lowers tear delay, and gives one coin, bomb, and key.
Celtic Cross	162		You feel blessed	Grants a chance to trigger the Book of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 7 seconds.
Charm of the Vampire	62		Kills heal	Heals the character for half of a Red Heart for every 13 monsters killed.
Chemical Peel	154		DMG up	Tears fired from left eye do increased damage.
Chocolate Milk	69		Charge shots	Grants charged tears that deal greater damage when fully charged.
The Common Cold	103		Poison Damage	Adds a chance to shoot poison tears, dealing damage over time when inflicted.
Continuum	369		Transcendent tears	+2.25 range up. +1.5 tear height. Isaac's tears travel through walls and appear out of the opposite wall. Isaac's tears also travel over rocks and objects.
Cricket's Body	224		Tears up + splash damage	Grants -1 tear delay and reduces range. When tears hit an object or deplete their range, they spawn 4 smaller tears, whose range and damage scale with Isaac's.
Cricket's Head	4		DMG up	Increases damage by 0.5, and multiplies it by 1.5x.
Cube of Meat	73		Gotta meat 'em all!	Orbiting familiar that blocks enemy shots and deals damage to enemies. If collected while already having one, it makes the familiar evolve. Only drops from Horsemen. Similar to Ball of Bandages.
Cupid's Arrow	48		Piercing shots	Grants Isaac piercing tears that travel through enemies (but not obstacles) instead of breaking on impact with them.
Curse of the Tower	371		You feel cursed...	Causes Isaac to spawn 6 Troll Bombs on the floor every time he gets hit, similar to the Anarchist Cookbook mechanic.
Cursed Eye	316		Cursed charge shot	Grants charged tears that can be fired in a tight burst of four. Getting hit while charging will teleport Isaac into another room.
Daddy Longlegs	170		Daddy's love	Daddy Long Legs' shadow follows Isaac and stomps on enemies.
Dead Bird	117		Protective buddy	Spawns a flying familiar for the current room that chases enemies whenever Isaac takes damage.
Dead Eye	373		Accuracy brings power!	Isaac's damage increases each time an enemy is hit. Damage is reset upon missing a shot.
Dead Onion	336		Toxic aura tears	Grants piercing and spectral tears. Increases tear size (without increasing damage) while greatly reducing range and shot speed.
Death's Touch	237		Penetrative shot + damage up	+1.5 damage, -0.3 tears. Tears are replaced with large piercing scythes.
Deep Pockets	416		More stuff to carry!	Allows Isaac to carry two cards or pills (or a combination of both) at the same time.
Distant Admiration	57		Attack fly	A red attack fly circles further out than the Halo of Flies / Pretty Flies, but closer than Forever Alone. Deals more damage than Forever Alone.
Dr. Fetus	52		???	Tears are replaced by bombs that benefit from bomb-enhancing effects and slide for a fixed time after being fired.
Dry Baby	265		Immortal Friend	Spawns a familiar that follows Isaac around and blocks enemy projectiles. Upon blocking a shot, it has a chance of triggering The Necronomicon effect.
E Coli	236		Turdy touch	Gives "Turdy Touch" effect. Enemies that touch Isaac are changed into poop.
Epic Fetus	168		On-demand air strike	Isaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
Epiphora	368		Intensifying tears	Shooting in one direction increases Isaac's rate of fire until the cap is reached. As soon as Isaac changes direction or stops shooting, rate of fire is reset to its normal amount.
Eve's Mascara	310		Shot speed down + DMG up	Doubles damage, halves tears stat, and greatly reduces shot speed.
Evil Eye	410		Eye shot!	While firing tears, Isaac has a chance to fire an eye across the screen with a very slow shot speed, which will fire tears of its own in the same direction as Isaac. The eye will be destroyed if it comes into contact with an enemy or obstacle.
Explosivo	401		Sticky bomb shot!	Isaac's tears have a chance to stick to enemies and explode.
Fire Mind	257		Flaming tears	Grants flaming tears that deal burning damage over time. Tears have a chance to explode on impact with an enemy, which creates a fire at the location of the explosion.
Forever Alone	128		Attack fly	Spawns a blue attack fly that orbits a long distance from Isaac.
Friend Zone	364		Friendly fly	A white orbiting fly which deals 3 contact damage per tick to enemies. This familiar orbits Isaac at a middle length distance somewhere between Distant Admiration and Forever Alone.
Gemini	318		Conjoined friend	Suture becomes attached to Isaac, and does touch damage to enemies within its attacking range.
Ghost Baby	163		Spectral buddy	Spawns a familiar that follows Isaac around and fires spectral tears.
Glitter Bombs	432		Prize bombs!	Gives Isaac 5 bombs, and makes Isaac's bombs have a chance to drop random pickups or charm enemies when they explode.
Gnawed Leaf	210		Unbreakable	After standing still and not shooting for a short time, Isaac turns invincible until he moves or shoots.
God's Flesh	398		Shrink shot	Tears now have a random chance to apply a shrinking effect, causing enemies to shrink in size and also run away from Isaac. Shrunk enemies can be crushed and killed by walking over them.
Godhead	331		God tears	Increases damage and range while reducing tears and shot speed. Grants homing tears and tears gain a damaging halo.
Guillotine	206		An out-of-body experience	Isaac's head is removed from his body and floats around him. Increases Damage by 1 and grants -1 Tear Delay.
The Halo	101		All stats up	Grants one Heart Container, +0.3 Damage, +0.2 Tears, +0.25 Range, +0.3 Speed, and +0.5 Tear Height.
Halo of Flies	10		Projectile protection	Spawns two Pretty Flies that block enemy shots and deal contact damage to flies.
Harlequin Baby	167		Double shot buddy	Spawns a familiar that follows Isaac around and fires two tears at once in a V-pattern.
Headless Baby	269		Bloody Friend	Familiar that follows Isaac, leaving blood creep on the ground.
Holy Light	374		Holy shot!	Isaac has a random chance to fire a Holy tear, which, when it hits an enemy, will spawn a Crack the Sky-style light beam on the same enemy, dealing damage.
Host Hat	375		Nice hat!	A host familiar that sits on Isaac's head and has a random chance to block enemy shots and retaliate with 3 tears. Grants immunity to explosions.
Hot Bombs	256		Burning blast +5 bombs	Grants 5 bombs. Isaac's bombs leave behind fire that damages enemies upon contact.
Infamy	242		Damage Reduction	Chance to block projectiles coming from any direction.
Infestation	148		They grow inside	1-3 Blue Flies randomly spawn every time Isaac gets hit.
Infestation 2	234		Infestation shot	Spawns allied Blue Spiders from killed enemies.
The Inner Eye	2		Triple shot	Grants triple shot but decreases tears.
Ipecac	149		Explosive shots	Replaces tears with explosive and poisoning projectiles fired in an arc from the mouth.
Iron Bar	201		Concussive tears	Increases damage by 0.3 and adds a chance to shoot concussive tears, causing enemies to walk around randomly.
Judas' Shadow	311		Sweet revenge	Adds an extra life; upon death, it respawns Isaac as Black Judas with only two black hearts.
Juicy Sack	266		Sticky babies	A familiar that follows behind Isaac. It drips a trail of creep, which slows enemies, and spawns 1-2 blue spiders after each room.
Kidney Stone	440		Matt's kidney stone	Randomly while firing tears, Isaac will stop firing and turn red, where he will charge and release a lot of 'tears' in one go. The burst of tears also includes a kidney stone, which deals a lot of damage.
Lazarus' Rags	332		Eternal Life?	Upon dying, resurrect as Revived Lazarus with one heart container and Anemic item.
Leo	302		Stompy	Isaac can destroy rocks by walking into them.
Lil Chest	362		What's in the box?	Spawns a chest familiar that follows Isaac and drops a random pickup every few rooms.
Lil Gurdy	384		A gurd of your own!	Gives Isaac a Gurdy familiar that will charge around the room dealing contact damage to enemies. Lil Gurdy is charged by holding down a fire button and letting go. The longer the button is held, the faster Lil Gurdy will fling itself across the screen. Lil Gurdy can pass over objects and obstacles in the room.
Lil Haunt	277		Fear him	A familiar that damages enemies by chasing them as well as inducing the fear effect.
Little C.H.A.D.	96		Gives kisses	A familiar who will drop a half red heart every 3 rooms.
Little Chubby	88		Attack Buddy	A charger familiar that charges forward and deals touch damage to any enemies in its path.
Little Gish	99		Sticky friend	Spawns a familiar that follows Isaac around and fires slowing tears, impeding enemies' speed.
Little Steven	100		Psychic friend	Spawns a familiar that follows Isaac around and fires homing tears.
Loki's Horns	87		Cross Tears	Gives a random chance for projectiles to fire in all 4 cardinal directions.
Lost Contact	213		Shielded tears	Every tear has a small shield which will allow it to block one enemy projectile.
Lost Fly	365		Lost protector	A familiar fly that moves in a straight line and attaches itself to the first obstacle or wall it comes into contact within each room. If any enemies walk into its path, it will do 7 contact damage per tick. If the obstacle it is attached to is destroyed then it will continue rolling in the direction it was previously traveling until it meets another wall or obstacle.
The Ludovico Technique	329		Controlled Tears	Instead of firing tears, Isaac controls one floating tear that hover over obstacles. This tear deals constant damage when held in place over an enemy.
Lusty Blood	411		Their blood brings rage!	Isaac's damage increases for the current room each time he kills an enemy.
Maggy's Bow	312		HP up + you feel healthy	Gives one heart container and doubles the healing provided by red hearts.
Magic Mushroom	12		All Stats Up!	Increases most stats, enlarges Isaac, grants a heart container and restores all health.
Marked	394		Directed tears	Isaac will now fire tears automatically directed at a red target on the ground which is controlled by the player. This allows for a full 360-degree tear firing radius. It can be overridden by other tear modifiers such as Mom's Knife or Brimstone.
Milk!	436		Don't cry over it...	A glass of milk follows Isaac and spills on the floor upon taking damage. After the milk spills, Isaac's tear delay is decreased by 2 for the rest of the room.
The Mind	333		I know all	Grants the combined effects of the Blue Map, Treasure Map, and The Compass, revealing the floor layout and all special rooms, including Secret Rooms and Super Secret Rooms.
Missing No.	258		Syntax error	Randomizes all passive items and stats upon pickup and at the start of each succeeding floor.
Mom's Contacts	110		Freeze effect	Adds a chance to shoot petrifying tears, which stop enemies in place and prevent them from moving or attacking. Range up.
Mom's Eyeshadow	200		Charm tears	Tears have a chance to charm enemies.
Mom's Eye	55		Eye in the back of your head	Allows Isaac to fire tears from the back of his head.
Mom's Knife	114		Stab stab stab	Isaac'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.
Mom's Perfume	228		Fear shot	Adds a chance to shoot fear tears and decreases tear delay by 1.
Monstro's Lung	229		Charged attack	Increases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.
Mr. Mega	106		Blast damage	Gives Isaac 5 bombs, and makes all dropped bombs larger, which have an increased blast radius and increased damage.
The Mulligan	151		They grow inside	Tears have a 1/6 chance of spawning allied blue flies when they hit an enemy.
Multidimensional Baby	431		ydduB Buddy	Spawns a familiar that will follow Isaac's movements on a 2.5-second delay. Tears that pass through the baby will be doubled and increase in speed.
Mutant Spider	153		Quad shot	Grants quadruple shot but decreases tears.
My Reflection	5		Boomerang tears	Gives Isaac's tears a boomerang effect, and increases range and shot speed.
Mysterious Liquid	317		Toxic Splash Damage	Tears leave a small, short lasting pool of creep on impact or when their range is depleted.
Mystery Sack	271		?	Spawns a familiar that drops a heart, coin, bomb, or key every 5-6 rooms.
Night Light	425		Scared of the dark?	A cone of light shines in the direction Isaac is moving that slows enemies and enemy shots.
No. 2	378		Uh oh...	Continuously firing tears for several seconds causes Isaac to drop a Butt Bomb. Butt Bombs explode for 60 damage like normal bombs, but also deal 10 damage to all enemies in the room and daze them for a short period of time.
Number One	6		Tears up	+1.5 tears, -17.62 range
Obsessed Fan	426		Follows my every move...	A purple fly familiar that follows Isaac's movements on a 3 second delay and deals contact damage to enemies.
Odd Mushroom	121		DMG up	Grants an empty heart container. Increases damage, range and shot height while reducing speed.
Odd Mushroom	120		Fire rate up	+1.7 tears, +0.3 speed, reduces damage.
Ouija Board	115		Spectral tears	Grants spectral tears that travel through obstacles (but not enemies) instead of breaking on impact with them.
Papa Fly	430		Turret follower	A blue fly familiar follows Isaac's movements on a 3 second delay. Papa Fly will fire tears at nearby enemies.
The Parasite	104		Split Shot	Isaac's tears split in two when they hit something.
Pay to Play	380		Money talks	+5 coins. Turns all doors that require a single key into doors which need a coin to enter instead. This affects shops, item rooms and libraries.
The Peeper	155		Plop!	Spawns a familiar that floats slowly around the room on a zig-zag pattern similar to Boom Flies damaging enemies it passes through.
Pisces	309		Tears up + knock-back shots	-1 Tear Delay, adds knock-back shots and increases tear size.
Polyphemus	169		Mega Tears	Isaac fires huge tears that deal massive damage but fire rate is greatly decreased. If a tear kills an enemy, the tear travels on with any leftover damage.
Proptosis	261		Short range mega tears	Tears start out massive with high damage, and then shrink down and become weaker over a short range.
Punching Bag	281		Scape Goat	Spawns a Mulligan Familiar that will wander the room randomly. Enemies will attack the Mulligan if it's closer.
Pupula Duplex	379		Wide shot	Gives Isaac spectral tears and gives his tears a wide arc shape, increasing their size.
Purity	407		Aura stat boost	Boosts one of Isaac's stats depending on the color of the aura around him. The aura disappears upon taking damage and reappears with a random color upon entering a new room. Red boosts damage, blue boosts tears, yellow boosts speed, and orange boosts range.
Pyromaniac	223		It hurts so good +5 Bombs	Isaac heals 1 heart instead of taking damage from an explosive source. Adds 5 bombs.
Pyro	190		99 bombs	Adds 99 bombs.
Rotten Baby	268		Infested friend	A familiar that spawns blue flies.
Rubber Cement	221		Bouncing tears	Tears bounce off walls, enemies, and environmental objects.
Rune Bag	389		Rune generator	A bag that follows Isaac and drops a random rune every 5-6 rooms.
Sack of Pennies	94		Gives money	Isaac is followed by a small bag that drops a coin every 2 rooms.
Sacrificial Dagger	172		My fate protects me	A dagger orbits Isaac, dealing very high damage and blocking enemy shots.
Sad Bombs	220		Tear blast +5 bombs	+5 Bombs. Upon exploding, bombs shoot 8 tears off in every direction, similar to Tammy's Head. The tears are affected by any tear modifiers Isaac has on his own tears.
The Sad Onion	1		Tears up	Increases Tears by 0.7.
Sagittarius	306		Penetrative shot + speed up	Increases speed by +0.2 and grants piercing tears.
Samson's Chains	321		The ol' ball and chain	Spawns a ball and chain familiar Isaac pulls behind him that damages enemies, blocks shots, and destroys rocks.
Scapular	142		You have been blessed	Once per room, when Isaac is reduced to his last half red Heart, the aura around his head temporarily vanishes and he is granted one Soul Heart.
Scatter Bombs	366		We put bombs in your bombs!	Adds 5 bombs. Isaac's bombs explode into 2-4 tiny bombs.
Scorpio	305		Poison tears	Grants poison tears, which deal damage over time when inflicted.
Serpent's Kiss	393		The kiss of death	Tears have a random chance to apply a poison effect to enemies. Isaac now deals poison damage on contact. Enemies that were poisoned have a chance to drop a black heart when killed.
Sissy Longlegs	280		She loves you	Wanders about the room, occasionally spawning Blue Spiders.
Sister Maggy	67		Friends 'till the end	A familiar that follows Isaac around shooting blood tears.
Smart Fly	264		Revenge fly	After Isaac takes damage, this fly will do continuous touch damage to whatever enemy caused the damage until it is dead. The fly will then systematically attack 1 enemy at a time until the room is cleared.
The Soul	335		I am all	Grants two soul hearts. Isaac gains a pulsing aura that repels enemies and projectiles.
Soy Milk	330		DMG Down + Tears Way Up	Tears shrink and do much less damage, but fire in very rapid succession.
Spider Bite	89		Slow effect	Adds a chance to shoot slowing tears, reducing speed of enemy movement and any projectile fired by them.
Spoon Bender	3		Homing shots	Grants Isaac homing tears.
Steam Sale	64		50% off	Reduces all Shop prices by 50%, rounded down to 7 coins for an item, rounded up to 2-3 coins for a pickup.
Steven	50		DMG up	Increases Damage by 1.
Sticky Bombs	367		Egg sack bombs!	+5 bombs. Bombs stick to enemies and spawn 2-4 Blue Spiders if they kill an enemy.
Stigmata	138		DMG + HP up	Increases damage, and adds 1 heart container.
Strange Attractor	315		Magnetic tears	Pickups, trinkets, and monsters are magnetically attracted to Isaac's tears.
Taurus	299		Speed down + rage is building	Speed down; gains speed while in a room with enemies until gaining My Little Unicorn effect for a few seconds.
Tech X	395		Laser ring tears	Tears are replaced with laser rings that pierce through enemies and deal damage to enemies within them. Can be charged to increase the size of the ring.
Tech.5	244		It's still being tested...	Isaac occasionally fires an unlimited range piercing laser alongside his normal tears. The laser can glitch, mimicking the effects of certain items and trinkets.
Technology	68		Laser tears	Replaces tears with a piercing laser with unlimited range.
Technology 2	152		Laser	Decreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously.
Tiny Planet	233		Orbiting tears + range up	Range up and makes shot tears revolve around Isaac until they drop.
Tough Love	150		Tooth shot	Adds a chance to shoot a tooth instead of a tear, which deals greater damage than regular tears.
Tractor Beam	397		Control your tears	Increases tears, range, and shot speed. Isaac emits a beam from his face that his tears follow along.
Virgo	303		You feel refreshed and protected	Adds a chance to give a shield that nullifies all incoming damage for 10 seconds upon taking damage. Also converts bad pills into good pills.
The Virus	13		Poison touch	Inflicts poison to enemies who make contact with Isaac. Speed down. Poisoned enemies have a chance to drop a black heart when killed.
The Wafer	108		Damage resistance	All sources of damage that would cause more than one-half heart of damage are reduced to one-half heart instead.
The Wiz	358		Double wiz shot!	Tears simultaneously fire out of both eyes diagonally, similar to the effect of the R U A Wizard? pill. Isaac's tears also travel above all obstacles.
Zodiac	392		The heavens will change you	Gives Isaac a random zodiac item effect that changes every floor.
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.
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.
Big Chubby	473		Chub chub	Spawns a fat charger familiar that slowly charges forward, blocking shots and damaging enemies in its path.
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.
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.
Dead Tooth	446		Halitosis	While firing, Isaac gains a green aura that poisons nearby enemies.
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.
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.
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 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.
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.
Mom's Wig	217		You feel itchy...	Adds a chance to spawn blue spiders when firing tears. Restores 1 red heart.
Mongo Baby	322		Mongo Friend	Summons a familiar that copies the tears of Isaac's other familiars.
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.
Rainbow Baby	174		Random buddy	Spawns a familiar that follows Isaac around and fires tears with random effects.
The Relic	98		Soul generator	Isaac is followed by a small blue cross that will drop a Soul Heart every 5-6 rooms.
Robo-Baby	95		Friends 'till the bbbbzzzt	Follows Isaac around, shooting enemies with an eye laser similar to Technology.
Robo-Baby 2.0	267		We worked out all the kinks	Fires lasers at any enemy in its line of sight and moves based on the direction Isaac is firing tears.
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.
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 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.
Match Book	344		Evil up	Grants Isaac 1 Black Heart and 3 bombs. Can also give troll bombs.
Metal Plate	449		It itches...	Grants one soul heart. Enemy shots have a chance to be reflected at the shooter as confusing tears.
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.
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.
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.
Technology Zero	524		Static tears!	Connects Isaac's tears with electricity that can damage enemies.
Varicose Veins	452		I'm leaking...	Taking damage releases a ring of 10 high damage tears.