Hard mode

Hard mode changes the gameplay compared to Normal in some ways to make it more difficult. When playing in hard mode, a small red pentagram () appears on the HUD, below the consumables.

• Rooms contain more advanced enemies and in a higher number.
• Causes champions to spawn more often; however, they award fewer pickups.
• You are 65% less likely to receive hearts after completing a room.
• Only champion bosses can drop red hearts; normal bosses will not.
• You are more likely to be cursed on each floor.
• You are more likely to receive a harder version of a floor (e.g. Necropolis or Dank Depths instead of The Depths).

Unlocks for Hard Mode

Character	Mom's Heart	All Completion Marks
Isaac	Template:Achv	Template:Achv
Magdalene	Template:Achv	Template:Achv
Cain	Template:Achv	Template:Achv
Judas	Template:Achv	Template:Achv
???	Template:Achv	Template:Achv
Eve	Template:Achv	Template:Achv
Samson	Template:Achv	Template:Achv
Azazel	Template:Achv	Template:Achv
Lazarus	Template:Achv	Template:Achv
Eden	Template:Achv	Template:Achv
The Lost	Template:Achv	Template:Achv
Lilith	Template:Achv	Template:Achv
Keeper	Template:Achv	Template:Achv
Apollyon	Template:Achv	Template:Achv
The Forgotten	Template:Achv	Template:Achv

Trivia

• Prior to update 1.03, the reduced drop-rate affected all Pickups (not just Red Hearts).
• Godhead's unlock requirements were extended in the Afterbirth DLC (and further extended in the Afterbirth+ DLC) due to the addition of more completion marks, but it can still be unlocked in the base game using the same method.

The Binding of Isaac: Rebirth
Achievements Challenges Completion Marks Items Trinkets Characters Chapters Rooms Transformations Attributes Bosses Monsters Pickups Modes Curses Objects Seeds Effects Endings
Collection Item Pools Version History Modding Music