Treasure Room (Item Pool)

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Item Pool
Removed in Afterbirth Rebirth Treasure Room Shop Library Curse Room Boss Secret Room Devil Room Angel Room Golden Chest Red Chest Beggar Devil Beggar Key Master
Added in Afterbirth Afterbirth Treasure Room Shop Library Curse Room Boss Secret Room Devil Room Angel Room Golden Chest Red Chest Beggar Devil Beggar Key Master Bomb Bum
Added in Afterbirth Greed Mode Treasure Room Shop Library Curse Room Boss Secret Room Devil Room Angel Room Golden Chest
Added in Afterbirth † Afterbirth † Treasure Room Shop Library Curse Room Boss Secret Room Devil Room Angel Room Golden Chest Red Chest Beggar Devil Beggar Key Master Bomb Bum
Added in Afterbirth † Greed Mode Treasure Room Shop Library Curse Room Boss Secret Room Devil Room Angel Room Golden Chest

The Treasure Room item pool contains the majority of the game's items. All of the items in this pool are able to be found in the Treasure Room.

Activated Collectibles[edit | edit source]

Name ID Icon Quote Description
Anarchist Cookbook 65
Anarchist Cookbook
3 rooms
Summon bombs Spawns six troll bombs around the room.
The Bean 111
The Bean
1 rooms
Toot on command Isaac releases bad gas, poisoning any enemy in close vicinity.
Best Friend 136
Best Friend
3 rooms
Friends 'till the end Deploys a decoy Isaac that eventually explodes with an increased blast radius.
Blank Card 286
Blank Card
4 rooms
Card Mimic Has the same effect as the card or rune currently held by Isaac.
Blood Rights 186
Blood Rights
Unlimited
Mass enemy damage at a cost Damages all enemies in the room, but deals a heart of damage to Isaac with each use.
Bob's Rotten Head 42
Bob's Rotten Head
3 rooms
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.
Book of Revelations 78
Book of Revelations
6 rooms
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).
Book of Secrets 287
Book of Secrets
6 rooms
?????? Upon use, gives the effect of Treasure Map, The Compass, or Blue Map for the duration of the current floor.
Book of Shadows 58
Book of Shadows
3 rooms
Temporary Invincibility Upon use, creates a protective shield nullifying all types of damage for 10 seconds.
The Book of Sin 97
The Book of Sin
4 rooms
Reusable Item Generator Spawns a random pickup, pill, card, or trinket.
Box of Spiders 288
Box of Spiders
2 rooms
It's a box of spiders Summons 2-4 blue spiders.
Butter Bean 294
Butter Bean
3 seconds
Reusable knock-back Isaac farts and pushes back nearby enemies.
Crack the Sky 160
Crack the Sky
4 rooms
Holy white death Summons multiple beams of light in random locations around the room, dealing a large amount of damage to any enemy that touches them.
Crystal Ball 158
Crystal Ball
6 rooms
I see my future Reveals the map (except the Super Secret Room) and drops a random Tarot Card or soul heart.
D4 284
D4
6 rooms
Reroll into something else Rerolls all of Isaac's items.
The D6 105
The D6
6 rooms
Reroll Your Destiny Allows Isaac to re-roll collectible items in the current room into other items, depending on the current room's Item Pool.
D10 285
D10
1 rooms
Rerolls enemies Rerolls the enemies in a room. Only rerolls enemies that are still alive (does not spawn new enemies).
D20 166
D20
6 rooms
Reroll the basics Rerolls all pickups in the current room.
D100 283
D100
6 rooms
REEROLLLLL! Upon use, rerolls all passive items on Isaac like the D4, every pedestal item in the room like The D6, and every pickup like the D20.
Dad's Key 175
Dad's Key
2 rooms
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
Dead Sea Scrolls
2 rooms
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
Deck of Cards
6 rooms
Reusable Card Generator Gives Isaac a random Tarot Card.
Doctor's Remote 47
Doctor's Remote
2 rooms
Reusable Air Strike Sets a big red target on the ground (similar to the Epic Fetus item) which can be controlled with tear controls. After 6 seconds or by pressing space again, a huge explosive missile hits it, which damages all enemies caught in its blast radius.
Flush! 291
Flush!
6 rooms
... Changes all enemies in the room into poop. Does not work on all enemies (Knights and bosses are immune). Instantly kills Dingle, Dangle, and Brownie.
Forget Me Now 127
Forget Me Now
One time use
I don't remember When activated, the level ends and is freshly regenerated with new rooms, monsters, and items. Disappears after use.
The Gamekid 93
The Gamekid
6 rooms
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.
The Hourglass 66
The Hourglass
2 rooms
Temporary enemy slowdown Upon activation, enemies and their projectiles are slowed down for a short duration.
How to Jump 282
How to Jump
Unlimited
It's about time you learned how Gives Isaac the ability to jump (over gaps, spikes, etc.).
Isaac's Tears 323
Isaac's Tears
6 rooms
Collected tears Shoots 8 tears around Isaac, which retain the damage, shot speed, and special effects of his tears. Each tear shot by Isaac increases item charge by one.
Kamikaze! 40
Kamikaze!
Unlimited
Become the bomb! Creates an explosion in the same area as Isaac, dealing half a heart of damage to him and also damaging all enemies caught in the blast radius.
Lemon Mishap 56
Lemon Mishap
2 rooms
Oops... Creates a small yellow pool of creep, which damages enemies that cross it.
Magic Fingers 295
Magic Fingers
Unlimited
Pay to play For 1 coin, damages all enemies in the room.
Mom's Bottle of Pills 102
Mom's Bottle of Pills
6 rooms
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.
Mom's Bra 39
Mom's Bra
3 rooms
Mass Fear Upon use, petrifies all enemies in the current room for approximately 4 seconds.
Mom's Pad 41
Mom's Pad
3 rooms
Gross... Upon use, inflicts fear to all enemies in the room for 5 seconds.
Monster Manual 123
Monster Manual
3 rooms
Temporary buddy generator Summons a random familiar for the current room. Can summon familiars not yet unlocked.
Monstro's Tooth 86
Monstro's Tooth
3 rooms
Summon Monstro Monstro jumps onto a random enemy, doing area damage. Can damage/kill the player if summoned in an room without enemies.
Mr. Boom 37
Mr. Boom
2 rooms
Reusable bomb buddy Drops a large bomb.
My Little Unicorn 77
My Little Unicorn
6 rooms
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.
Notched Axe 147
Notched Axe
3 rooms
Rocks don't stand a chance Isaac holds the axe above his head for as long as the spacebar button is held (or until he leaves the room). While holding the axe, Isaac can break any rock he touches, but cannot attack or pick up other items.
The Pinking Shears 107
The Pinking Shears
6 rooms
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.
The Poop 36
The Poop
1 rooms
Plop! Spawns a pile of poop where the character is standing and knocks nearby monsters back. May yield pickups like regular poop.
Prayer Card 146
Prayer Card
6 rooms
Reusable eternity Grants an eternal heart per use.
Remote Detonator 137
Remote Detonator
Unlimited
Remote bomb detonation Bombs you place explode only when you use this item. Gives 5 bombs.
Satanic Bible 292
Satanic Bible
6 rooms
Reusable Evil Upon activation, Isaac gains a black heart.
Scissors 325
Scissors
6 rooms
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.
Shoop Da Whoop! 49
Shoop Da Whoop!
2 rooms
BLLLARRRRGGG! Fires a laser from Isaac's mouth.
Spider Butt 171
Spider Butt
2 rooms
Mass enemy slowdown + damage Damages all enemies in the room and slows them and their projectiles down.
Telepathy for Dummies 192
Telepathy for Dummies
2 rooms
Temporary psychic shot Upon activation, grants homing tears for the current room.
Teleport 44
Teleport
2 rooms
Teleport! Teleports you to a random room on the level.
Undefined 324
Undefined
6 rooms
Undefined Teleports Isaac to either the Secret Room, Super Secret Room, Treasure Room, or I AM ERROR.
Unicorn Stump 298
Unicorn Stump
1 rooms
You feel stumped Upon use, grants invulnerability and increased speed for five seconds, but removes the ability to shoot tears.
Yum Heart 45
Yum Heart
4 rooms
Reusable Regeneration Restores 1 whole red heart.

Passive Collectibles[edit | edit source]

Name ID Icon Quote Description
20/20 245 20/20 Double shot Grants double shot.
3 Dollar Bill 191 3 Dollar Bill Rainbow tears Gives Isaac a random tear effect every room.
Removed in Afterbirth The effect given changes upon entering a room.
Added in Afterbirth The effect changes every 3 seconds.
???'s Only Friend 320 ???'s Only Friend Controlled friend Summons a big attack fly that can be controlled with the shooting direction-keys.
A Quarter 74 A Quarter +25 coins Adds 25 to Isaac's coin count, capping at 99.
Abel 188 Abel Mirrored buddy A familiar that mirrors the player's movements and shoots in the opposite direction.
Anemic 214 Anemic 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 Ankh Eternal life? Upon death, the player will respawn as ??? with 3 soul hearts.
Anti-Gravity 222 Anti-Gravity 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 Aquarius Trail of tears A trail of blue creep is left behind Isaac, which damages enemies.
Aries 300 Aries Ramming speed +0.25 Speed. Running into enemies while at a high speed will deal 18 points of damage. Does not prevent contact damage.
BBF 272 BBF Big Beautiful Fly Spawns a familiar that flies around the room in a manner similar to the Boom Fly and explodes on contact with an enemy. Respawns after ten seconds.
Ball of Tar 231 Ball of Tar 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 Best Bud Sworn protector When hit, summons a white attack fly similar to Distant Admiration for the current room.
Big Fan 279 Big Fan Fat protector Spawns a large orbital familiar that blocks enemy projectiles and deals slight contact damage to enemies.
The Black Bean 180 The Black Bean Toot on touch When taking damage, Isaac farts, causing poison damage to all enemies in range.
Blood of the Martyr 7 Blood of the Martyr DMG up Increases Damage by 1, and turns Isaac's tears into blood tears.
Bloody Lust 157 Bloody Lust RAGE! Increases damage as Isaac receives damage. Damage increase stays for the whole floor.
Bob's Brain 273 Bob's Brain 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 Bob's Curse +5 poison bombs Gives 5 bombs and grants all bombs poison effect.
Bobby-Bomb 125 Bobby-Bomb Homing bombs! Gives Isaac 5 Bombs, and causes all dropped bombs to home towards the closest enemy.
The Body 334 The Body I feel all Adds 3 heart containers.
Bomb Bag 131 Bomb Bag Gives bombs Isaac is followed by a small bag that drops a Bomb, 1+1 Free, or a Troll Bomb every 3 rooms.
Boom! 19 Boom! 10 bombs Grants 10 bombs.
Brother Bobby 8 Brother Bobby Friends 'till the end Follows Isaac around shooting normal tears.
Bucket of Lard 129 Bucket of Lard HP up Grants two empty heart containers and heals Isaac by half a heart, but decreases speed by 0.2.
Bum Friend 144 Bum Friend He's greedy A portable beggar who follows Isaac, picks up coins for himself, and occasionally drops a pickup after collecting a coin. Does not spawn collectibles.
Butt Bombs 209 Butt Bombs Toxic blast +5 bombs Gives +5 bombs and makes all bombs Butt Bombs that fill the room with gas, damaging and confusing all enemies.
Cain's Other Eye 319 Cain's Other Eye 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 Cancer HP up + you feel protected Adds 3 soul hearts. Grants The Wafer effect for the current room upon taking damage.
Capricorn 307 Capricorn All stats up All stats up.
Celtic Cross 162 Celtic Cross 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 Charm of the Vampire Kills heal Heals the character for half of a red heart for every 13 monsters killed.
Chemical Peel 154 Chemical Peel DMG up Tears fired from left eye do increased damage.
Chocolate Milk 69 Chocolate Milk Charge shots Grants charged tears that deal greater damage when fully charged.
The Common Cold 103 The Common Cold Poison Damage Adds a chance to shoot poison tears, dealing damage over time when inflicted.
Cricket's Body 224 Cricket's Body 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 Cricket's Head DMG up Increases damage by 0.5, and multiplies it by 1.5x.
Cupid's Arrow 48 Cupid's Arrow Piercing shots Grants Isaac piercing tears that travel through enemies (but not obstacles) instead of breaking on impact with them.
Cursed Eye 316 Cursed Eye 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 Longlegs Daddy's love Daddy Long Legs' shadow follows Isaac and stomps on enemies.
Dark Bum 278 Dark Bum He wants to take your life Spawns a familiar that follows Isaac around and collects red hearts. For every one-and-a-half red hearts collected, Dark Bum will generate one soul heart, one hostile Spider or one friendly blue spider.
Dead Bird 117 Dead Bird Protective buddy Spawns a flying familiar for the current room that chases enemies whenever Isaac takes damage.
Dead Onion 336 Dead Onion 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 Death's Touch Penetrative shot + damage up Increases Damage by 1.5, reduces Tears by 0.3 and increases tear size. Grants piercing tears. Tears are replaced by Death's scythes, which is a cosmetic effect only.
Demon Baby 113 Demon Baby Auto-turret friend Follows Isaac and automatically fires at enemies in its reach.
Distant Admiration 57 Distant Admiration 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 Dr. Fetus ??? Tears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.
Dry Baby 265 Dry Baby 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 E Coli Turdy touch Gives "Turdy Touch" Effect. Enemies that touch Isaac are changed into poop.
Epic Fetus 168 Epic Fetus On-demand air strike Isaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
Eve's Mascara 310 Eve's Mascara Shot speed down + DMG up Doubles damage, halves tears stat, and greatly reduces shot speed.
Experimental Treatment 240 Experimental Treatment All stats up, then shuffled Randomly increases and decreases some of the character's stats. There will always be at least one stat increase and one decrease and the same stats can be increased/decreased multiple times.
Fire Mind 257 Fire Mind 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 Forever Alone Attack fly Spawns a blue attack fly that orbits a long distance from Isaac.
Gemini 318 Gemini Conjoined friend Suture becomes attached to Isaac, and does touch damage to enemies within its attacking range.
Ghost Baby 163 Ghost Baby Spectral buddy Spawns a familiar that follows Isaac around and fires spectral tears.
Gimpy 225 Gimpy Sweet Suffering Has a chance of spawning a soul heart or black heart when taking damage. Enemies have a chance to drop a Half Red Heart after being killed.
Gnawed Leaf 210 Gnawed Leaf Unbreakable After standing still and not shooting for a short time, Isaac turns invincible until he moves or shoots.
Guillotine 206 Guillotine 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 The Halo 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 Halo of Flies Projectile protection Spawns two pretty fly familiars that block enemy shots and deal contact damage to enemies.
Harlequin Baby 167 Harlequin Baby Double shot buddy Spawns a familiar that follows Isaac around and fires two tears at once in a V-pattern.
Headless Baby 269 Headless Baby Bloody Friend Familiar that follows Isaac, leaving blood creep on the ground.
Holy Mantle 313 Holy Mantle Holy shield Automatically negates first taken damage in every room.
Holy Water 178 Holy Water Splash! When Isaac receives damage, the bottle breaks and a puddle of blue creep forms, which damages non-flying enemies, similar to Lemon Mishap. The bottle is reformed upon entering a different room.
Hot Bombs 256 Hot Bombs Burning blast +5 bombs Grants 5 bombs. Isaac's bombs leave behind fire that damages enemies upon contact.
Infamy 242 Infamy Damage Reduction Chance to block projectiles coming from any direction.
Infestation 2 234 Infestation 2 Infestation shot Spawns allied blue spiders from killed enemies.
Infestation 148 Infestation They grow inside 1-3 Blue flies randomly spawn every time Isaac gets hit.
The Inner Eye 2 The Inner Eye Triple shot Grants triple shot but decreases tears.
Ipecac 149 Ipecac Explosive shots Replaces tears with explosive and poisoning projectiles fired in an arc from the mouth.
Iron Bar 201 Iron Bar Concussive tears Increases damage by 0.3 and adds a chance to shoot concussive tears, causing enemies to walk around randomly.
Isaac's Heart 276 Isaac's Heart Protect It Isaac himself is now immune to all damage, and a heart familiar appears and follows Isaac. If the heart is hurt, Isaac is hurt.
Judas' Shadow 311 Judas' Shadow Sweet revenge Adds an extra life; upon death, it respawns Isaac as Black Judas with only two black hearts.
Juicy Sack 266 Juicy Sack 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.
Lazarus' Rags 332 Lazarus' Rags Eternal Life? Upon dying, resurrect as Revived Lazarus with one heart container and Anemic item.
Leech 270 Leech Blood sucker Spawns a friendly familiar leech on the ground that hunts down enemies and heals you for half a heart each time it eats one.
Leo 302 Leo Stompy Allows you to crush rocks when you walk over them.
Libra 304 Libra You Feel Balanced Gives 6 coins, 6 bombs, and 6 keys and balances out all attributes.
Lil Brimstone 275 Lil Brimstone Evil Friend A Familiar that shoots a thin Brimstone beam. Must charge like Brimstone before shooting.
Lil Haunt 277 Lil Haunt Fear him A familiar that damages enemies by chasing them as well as inducing the fear effect.
Little C.H.A.D. 96 Little C.H.A.D. Gives kisses A familiar who will drop a half red heart every 2 rooms.
Little Chubby 88 Little Chubby Attack Buddy A familiar that charges forward and deals touch damage to any enemies in its path.
Little Gish 99 Little Gish Sticky friend Spawns a familiar that follows Isaac around and fires slowing tears, impeding enemies' speed.
Little Steven 100 Little Steven Psychic friend Spawns a familiar that follows Isaac around and fires homing tears.
Loki's Horns 87 Loki's Horns Cross Tears Gives a random chance for projectiles to fire in all 4 cardinal directions.
Lost Contact 213 Lost Contact Shielded tears Every tear has a small shield which will allow it to block one enemy projectile.
Lucky Foot 46 Lucky Foot Luck up +1 Luck. Increases chance of winning Shell Game Beggar. (Independent of luck stat)
The Ludovico Technique 329 The Ludovico Technique 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.
Maggy's Bow 312 Maggy's Bow HP up + you feel healthy Gives one heart container and doubles the healing provided by red hearts.
Magic Mushroom 12 Magic Mushroom All Stats Up! Increases all stats and enlargens Isaac.
Magneto 53 Magneto Item snatcher Pulls pickups towards Isaac.
Midas' Touch 202 Midas' Touch Golden touch Enemies that touch you are stunned and turn gold. Any enemy killed while in this state will drop a coin.
The Mind 333 The Mind 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.
Mini Mush 71 Mini Mush Speed + range up Increases Speed and Shot Height and decreases Isaac's size, but lowers Range.
Mitre 173 Mitre You Feel Blessed Grants a chance of converting any red hearts pickups into soul hearts instead.
Mom's Contacts 110 Mom's Contacts 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 Mom's Eyeshadow Charm tears Tears have a chance to charm enemies.
Mom's Eye 55 Mom's Eye Eye in the back of your head Allows Isaac to fire tears from the back of his head.
Mom's Knife 114 Mom's Knife 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 Mom's Perfume Fear shot Adds a chance to shoot fear tears and decreases tear delay by 1.
Mom's Wig 217 Mom's Wig You feel itchy... Adds a chance to spawn blue spiders when firing tears. Restores 1 red heart.
Money = Power 109 Money = Power $$$ = DMG Increases damage by 0.04 for every coin Isaac has, up to +3.96 damage at 99 coins.
Mongo Baby 322 Mongo Baby Mongo Friend Summons a familiar that copies the tears of Isaac's other familiars.
Monstro's Lung 229 Monstro's Lung Charged attack Increases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.
Mr. Mega 106 Mr. Mega Blast damage Gives Isaac 5 bombs, and makes all dropped bombs larger, which have an increased blast radius and increased damage.
The Mulligan 151 The Mulligan They grow inside Tears have a 1/6 chance of spawning allied blue flies when they hit an enemy.
Mutant Spider 153 Mutant Spider Quad shot Grants quadruple shot but decreases tears.
My Reflection 5 My Reflection Boomerang tears Gives Isaac's tears a boomerang effect, and increases range and shot speed.
Mysterious Liquid 317 Mysterious Liquid Toxic Splash Damage Tears leave a small, short lasting pool of creep on impact or when their range is depleted.
Mystery Sack 271 Mystery Sack ? Spawns a familiar that follows Isaac around and has a chance to drop a heart, coin, bomb, or key after clearing a room.
Number One 6 Number One Tears up +1.5 tears, -17.62 range
Odd Mushroom 121 Odd Mushroom DMG up Grants an empty heart container. Increases damage, range and shot height while reducing speed.
Odd Mushroom 120 Odd Mushroom Fire rate up +1.7 tears, +0.3 speed, reduces damage.
Ouija Board 115 Ouija Board Spectral tears Grants spectral tears that travel through obstacles (but not enemies) instead of breaking on impact with them.
The Parasite 104 The Parasite Split Shot Isaac's tears split in two when they hit something.
The Peeper 155 The Peeper Plop! Spawns a familiar that floats slowly around the room on a zig-zag pattern similar to Boom Flies damaging enemies it passes through.
PHD 75 PHD Better pills Converts all bad pills into good pills, spawns one pill pickup and restores health. Identifies all pills upon pickup.
Piggy Bank 227 Piggy Bank My life savings Gives 3 pennies on pick-up. Every time Isaac is damaged, he will drop one additional penny.
Pisces 309 Pisces Tears up + knock-back shots -1 Tear Delay, adds knock-back shots and increases tear size.
Polyphemus 169 Polyphemus Mega Tears Makes Isaac shoot one huge tear. Also reduces Tears to minimum. Damage increased . If tear does more damage than an enemy's life, the tear continues to travel with the extra remaining damage.
Proptosis 261 Proptosis 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 Punching Bag Scape Goat Spawns a Mulligan Familiar that will wander the room randomly. Enemies will attack the Mulligan if it's closer.
Pyromaniac 223 Pyromaniac It hurts so good +5 Bombs Isaac heals 1 heart instead of taking damage from an explosive source. Adds 5 bombs.
Pyro 190 Pyro 99 bombs Adds 99 bombs.
Rainbow Baby 174 Rainbow Baby Random buddy Spawns a familiar that follows Isaac around and fires tears with random effects.
The Relic 98 The Relic Soul generator Isaac is followed by a small blue cross that will drop a Soul Heart every 4 rooms.
Robo-Baby 2.0 267 Robo-Baby 2.0 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.
Robo-Baby 95 Robo-Baby Friends 'till the bbbbzzzt Follows Isaac around, shooting enemies with an eye laser similar to Technology.
Roid Rage 14 Roid Rage Speed and range up Increases speed by 0.6, range by 5.25, and tear height by 0.5.
Rosary 72 Rosary Faith up Adds 3 Soul Hearts and increases the chance for The Bible to appear in any item pool.
Rotten Baby 268 Rotten Baby Infested friend A familiar that spawns blue flies.
Rubber Cement 221 Rubber Cement Bouncing tears Tears bounce off walls, enemies, and environmental objects.
Sack of Pennies 94 Sack of Pennies Gives money Isaac is followed by a small bag that drops a coin every 2 rooms.
Sacrificial Dagger 172 Sacrificial Dagger My fate protects me Dagger orbits Isaac, dealing very high damage.
Sad Bombs 220 Sad Bombs 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 The Sad Onion Tears up Increases Tears by 0.7.
Sagittarius 306 Sagittarius Penetrative shot + speed up Increases speed by +0.2 and grants piercing tears.
Samson's Chains 321 Samson's Chains The ol' ball and chain Pull a chain and ball behind you that will damage enemies on contact and is able to break stones.
Scapular 142 Scapular 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.
Scorpio 305 Scorpio Poison tears Grants poison tears, which deal damage over time when inflicted.
Sissy Longlegs 280 Sissy Longlegs She loves you Wanders about the room, occasionally spawning blue spiders.
Sister Maggy 67 Sister Maggy Friends 'till the end A familiar that follows Isaac around shooting blood tears.
Smart Fly 264 Smart Fly Revenge fly After Isaac takes damage, this fly will deal 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 The Soul I am all Grants two soul hearts. Isaac now repels enemy projectiles.
Soy Milk 330 Soy Milk DMG Down + Tears Way Up Tears shrink and do much less damage, but fire in very rapid succession.
Speed Ball 143 Speed Ball Speed + shot speed up Increases speed by 0.3 and shot speed by 20%.
Spelunker Hat 91 Spelunker Hat See-through doors Reveals type of adjacent rooms, including location for secret rooms and super secret rooms.
Spider Bite 89 Spider Bite Slow effect Adds a chance to shoot slowing tears, reducing speed of enemy movement and any projectile fired by them.
Spider Baby 211 Spider Baby Spider revenge When hit, spawns up to 2 blue spiders.
Spoon Bender 3 Spoon Bender Homing shots Grants Isaac homing tears.
Stem Cells 176 Stem Cells HP up Adds one filled heart container and increases Shot Speed.
Stigmata 138 Stigmata DMG + HP up Increases damage, and adds 1 heart container.
Strange Attractor 315 Strange Attractor Magnetic tears Pickups, trinkets, and monsters are magnetically attracted to Isaac's tears.
Super Bandage 92 Super Bandage +2 hearts Grants one Heart Container and gives 2 Soul Hearts.
Taurus 299 Taurus 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.5 244 Tech.5 It's still being tested... Grants a unlimited range piercing laser with random rate of fire that does not replace tears. The laser might occasionally fire with the effect of a random item or trinket, such as Hook Worm, Spoon Bender or Tiny Planet.
Technology 2 152 Technology 2 Laser Decreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously.
Technology 68 Technology Laser tears Replaces tears with a piercing laser with unlimited range.
Thunder Thighs 314 Thunder Thighs HP up + speed down + you feel stompy Destroys rocks upon contact with Isaac. Adds one heart container and lowers Speed.
Tiny Planet 233 Tiny Planet Orbiting tears + range up Range up and makes shot tears revolve around Isaac until they drop.
Tough Love 150 Tough Love Tooth shot Adds a chance to shoot a tooth instead of a tear, which deals greater damage than regular tears.
Virgo 303 Virgo You feel refreshed and protected Grants a chance to trigger the Book of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 10 seconds. Also converts "bad pills" into "good pills".
The Virus 13 The Virus Poison touch Inflicts poison to enemies who make contact with Isaac. Speed down.
The Wafer 108 The Wafer Damage resistance All sources of damage that would cause more than one half heart of damage are reduced to one half heart instead.
X-Ray Vision 76 X-Ray Vision I've seen everything Reveals and opens all Secret Room and Super Secret Room entrances.