Enter the Gungeon
The Binding of Isaac: Repentance
Repentance Items (173)
Clear Rune
ItemID: 263
"Rune mimic"
Quality: 2
When used, copies the effect of the Rune or Soul stone you are holding (like the Blank Card)
Drops a random rune on the floor when picked up
The recharge time of this item depends on the Rune/Soul Stone held:
1 room: Soul of Lazarus
2 rooms: Rune of Ansuz, Rune of Berkano, Rune of Hagalaz, Soul of Cain
3 rooms: Rune of Algiz, Blank Rune, Soul of Magdalene, Soul of Judas, Soul of ???, Soul of the Lost
4 rooms: Rune of Ehwaz, Rune of Perthro, Black Rune, Soul of Isaac, Soul of Eve, Soul of Eden, Soul of the Forgotten, Soul of Jacob and Esau
6 rooms: Rune of Dagaz, Soul of Samson, Soul of Azazel, Soul of Apollyon, Soul of Bethany
12 rooms: Rune of Jera, Soul of Lilith, Soul of the Keeper
Type: Active
Recharge Time: Varies
Item Pool: Secret Room, Crane Game
Mucormycosis
ItemID: 553
"Spore shot"
Quality: 3
Tears have a chance to fire a fungus tear that sticks to enemies. It grows rapidly in size then explodes into a gas cloud that damages nearby enemies
When the explosion happens, more homing fungus tears fire out in random directions. Those tears will cause the same effect if they happen to hit other enemies
Effects that replace your tears such as Brimstone simply have a chance to apply this effect
Type: Passive
Item Pool: Item Room
2Spooky
ItemID: 554
"4me"
Quality: 1
Any enemies that come within close range of Isaac will become feared, which causes them to flee
Type: Passive
Item Pool: Devil Room
Golden Razor
ItemID: 555
"Pain from gain"
Quality: 1
+5 coins when picked up
When used, this item takes away 5 of your coins and gives a +1.2 Damage Up that lasts for the current room
Can stack as many times as you want. Using it with less than 5 coins does nothing
Unlock this item by collecting 99 coins then spending all of them in the same run
Type: Active
Recharge Time: Instant
Item Pool: Item Room, Greed Mode Item Room
Sulfur
ItemID: 556
"Temporary demon form"
Quality: 2
Upon use, grants use of Brimstone for the current room
If used twice in the same room, the brimstone laser becomes massive and deals +1.8 more damage
Using it more than twice in the same room will give a damage increase each time
Counts as 1 of 3 evil items needed towards the Leviathan transformation.
Type: Active
Recharge Time: 3 rooms
Item Pool: Devil Room
Fortune Cookie
ItemID: 557
"Reusable fortunes"
Quality: 2
Upon use, displays a random fortune and has a chance to drop either a soul heart, a card (including dice shards), rune/soul stone or a trinket
Soul hearts and tarot cards are much more common than trinkets
Type: Active
Recharge Time: 2 rooms
Item Pool: Item Room
Eye Sore
ItemID: 558
"More eyes"
Quality: 1
With each tear fired, you have a chance to fire 1-3 extra tears in random directions
The extra tears scale with your other damage increasing items
Synergises with other items that replace your tears, like Brimstone or Technology
The chance to fire extra tears is not affected by luck
Type: Passive
Item Pool: Item Room
120 Volt
ItemID: 559
"Zap!"
Quality: 2
This item will fire electricity at nearby enemies, dealing roughly x0.75 of your tear damage rapidly
The electricity can chain up to 4 enemies if they are close enough
On floors with water on the ground (Downpour, Flooded Caves, Dross) this effect chain onto enemies further away than it normally would
Type: Passive
Item Pool: Item Room
It Hurts
ItemID: 560
"No it doesn't..."
Quality: 1
Taking damage causes Isaac to fire a circle of 10 tears around him, each dealing 10 damage
After taking damage, you also gain a +1.2 Tears Up for the rest of the current room. Any subsequent hits give +0.4 Tears Up and will ignore the normal fire rate cap
Type: Passive
Item Pool: Item Room
Almond Milk
ItemID: 561
"DMG down + tears up + you feel nutty"
Quality: 1
Greatly increases tears (x4 fire rate)
Greatly decreases damage (x0.33 damage multiplier)
Individual tears gain random worm effects (e.g. Hook Worm, Wiggle Worm etc.)
Type: Passive, Tear Modifier
Item Pool: Item Room
Rock Bottom
ItemID: 562
"It's only up from there"
Quality: 3
Prevents your stats from being reduced any more for the rest of the run
e.g. Stat Down pills do nothing, and items like Experimental Treatment increase stats but don't reduce any
This effect works on items that apply negative stat modifiers, such as Soy Milk
This effect works for anything that gives temporary buffs, like Devil/Strength cards, or kill bonuses like Bloody Lust
If you somehow lose Rock Bottom, your stats will go back to normal
Unlock this item by defeating the Boss Rush as Jacob & Esau
Type: Passive
Item Pool: Secret Room
Nancy Bombs
ItemID: 563
"Random blast +5 bombs"
Quality: 2
+5 Bombs
Bombs now explode with a random effect (e.g. Poison, Homing, Prize Bombs)
In Antibirth this was called Enigma Bombs
Type: Passive
Item Pool: Item Room
A Bar of Soap
ItemID: 564
"Tears + shot speed up"
Quality: 3
+0.5 Tears Up
+0.2 Shot Speed Up
Type: Passive
Item Pool: Boss Room
Blood Puppy
ItemID: 565
"What a cute little thing!"
Quality: 1
Spawns a red worm familiar that chases enemies nearby around the room and deals 2 contact damage per tick
After killing a 15 enemies, Blood Puppy transforms into an aggressive version that will also attack Isaac by charging at him. Damaging the aggressive Blood Puppy will eventually return it to its normal state.
While aggressive, Blood Puppy deals 7.5 damage and drops half a red heart for every 10 enemies it kills.
After killing a 25 more enemies, it transforms again dealing 15 damage and destroying obstacles it charges into. Isaac takes a full heart if hurt by Blood Puppy and it drops a full red heart for every 10 enemies it kills.
Unlock this item by defeating Mother in the Corpse II as Lilith
Type: Passive, Familiar
Item Pool: Item Room, Red Chest, Curse Room
Dream Catcher
ItemID: 566
"Sweet dreams"
Quality: 2
During the transition between floors, this item shows you a preview of the item that will spawn in the item room, and the boss that will appear
This effect will work even if you have Curse of the Blind, but the item will still appear as a ? when entering the item room
Gives +1 Soul Heart when starting each new floor after picking this up
On XL floors both items are shown
Currently this effect doesn't work in Greed Mode - It will show 2 items but the item rooms will have different items in them
Type: Passive
Item Pool: Shop
Paschal Candle
ItemID: 567
"Keep the flame burning"
Quality: 3
Gives +0.4 Tears Up for each room completed without taking damage, up to a maximum of +2.0 Tears Up
When you take damage, the tears bonus is reset
Picking this item up counts and gives you a temporary +0.4 Tears Up as well
Type: Passive
Item Pool: Angel Room
Divine Intervention
ItemID: 568
"Double tap shield"
Quality: 2
Allows you to double-tap the shoot button to create a holy shield for 1 second that pushes enemies back and deals 10 damage to them if they touch it
The shield also reflects enemy shots and beams back at them for some extra damage
Can only be activated every 3 seconds (Shown by a white glow and a ticking noise)
Counts as 1 of 3 angel items needed towards the Seraphim transformation.
Unlock this item by defeating Hush as Bethany
Type: Passive
Item Pool: Angel Room
Blood Oath
ItemID: 569
"Bleed me dry"
Quality: 1
At the beginning of each new floor, this item will stab Isaac and reduce your red health down as much as it can without killing you. In exchange it gives you +0.05 Speed Up and Damage Up for every half a heart this item removes
The amount of Damage Up is (0.15 * FullHeartsRemoved ^ 2)
If Isaac is already at half a red heart when stabbed, no damage or speed increases are given
The damage from being stabbed can be avoided with invincibility, however no damage or speed stat increases are gained if you do
Type: Passive
Item Pool: Devil Room, Curse Room
Playdough Cookie
ItemID: 570
"Tasty rainbow"
Quality: 3
Your individual tears each gain a random effect from either: Poison, Fear, Slow, Freeze, Charm, Burning, Homing, Bleeding, x2 Damage or Reduced damage
Type: Passive, Tear Modifier
Item Pool: Item Room
Orphan Socks
ItemID: 571
"Speed up + your feet feel stronger"
Quality: 2
+2 Soul Hearts
+0.3 Speed Up
Allows you to walk on harmful floor effects without taking damage (e.g. spikes, creep). Doesn't include Curse Room doors or spiked rocks
Type: Passive
Item Pool: Secret Room
Eye of the Occult
ItemID: 572
"DMG up + range up + controlled tears"
Quality: 3
Tears can be controlled mid-flight using the directional keys
+1 Damage Up
+2.0 Range Up
-0.16 Shot Speed Down
Counts as 1 of 3 evil items needed towards the Leviathan transformation.
Type: Passive
Item Pool: Devil Room
Immaculate Heart
ItemID: 573
"Halo of tears"
Quality: 3
In addition to regular tears, Isaac will sometimes fire extra spectral tears that orbit around him
+1 HP Up
+20% damage multiplier (x1.2)
Fully heals all your red heart containers
Counts as 1 of 3 angel items needed towards the Seraphim transformation.
Type: Passive
Item Pool: Angel Room
Monstrance
ItemID: 574
"Purifying light"
Quality: 2
Isaac now emits a large light aura that damages nearby enemies 5 times per second while touching it
The visual effect is similar to the effect given to tears by the GodHead item
The aura deals more damage towards the center, ranging from 0.75 at max range to 4 damage when touching Isaac
Type: Passive
Item Pool: Angel Room
The Intruder
ItemID: 575
"Invasive friend"
Quality: 3
In addition to normal tears, Isaac now also fires a set of 4 quadshot tears with a slowing effect
The quadshot tears deal 1.5 damage each and do not scale with your damage upgrades
Upon taking damage, you have a chance to dislodge the spider from your face. It leaps at enemies, dealing contact damage and firing quad shots at them for the rest of the room
Counts as 1 of 3 spider items needed towards the Spider Baby transformation.
Type: Passive
Item Pool: Item Room
Dirty Mind
ItemID: 576
"Filthy friends"
Quality: 1
Each time you destroy a poop, this item will spawn 1-4 friendly Dip familiars that follow you, block shots and attack nearby enemies
Different poop types will spawn different types of Dip, each with their own effect
Golden poop dips can petrify enemies, turning them to gold for a few seconds. If the enemy dies while in this state they will drop 1-4 coins
Corn poop dips spawn 1 blue fly on death
Rainbow poop Dips charm enemies and have a chance to spawn 1/2 a red heart on death
Black poop Dips leave a trail of creep
White poop Dips have a small Hallowed Ground aura effect, increasing your damage and fire rate while standing in it.
Poops spawned by Tainted ??? and IBS also have special effects: Stone Dips deal 3.5 more damage and can take 6 hits before they die. Toxic Dips release a poison cloud when they move/die. Fire Dips burn enemies and leave a fire behind on death
All enemy dips become friendly.
Counts as 1 of 3 poop items needed towards the Oh Crap transformation.
Unlock this item by defeating challenge #36 (Scat Man)
Type: Passive
Item Pool: Item Room
Damocles
ItemID: 577
"A king's fortune... but at what cost?"
Quality: 2
When used, places a sword directly above Isaac's head and while active, will spawn an extra item for every item pedestal spawned
After getting hit once with the item activated, at any time without warning, the sword may fall, instantly killing Isaac regardless of his health
After being hit the sword has a 1/10000 chance every 4 frames to fall. This chance doesnt change if you take further damage
You effectively have a 4.4% chance for every minute that passes after taking damage to die
Self-inflicted damage i.e. Curse Rooms and Blood Donation Machines don't trigger this effect
Items with a price will spawn the extra item free of charge (i.e. in shops or devil rooms)
The only way to survive the falling sword is either through extra lives, by using items that would make you invincible, such as Gnawed Leaf or playing as The Lost. After the sword falls, extra items will no longer spawn
Unlock this item by defeating The Lamb as Jacob & Esau
Type: Active
Recharge Time: One time use
Item Pool: Devil Room
Free Lemonade
ItemID: 578
"Party time!"
Quality: 1
Upon use, spawns a giant puddle of lemonade that deals 8 damage per tick to any enemies which come in contact with it
Lasts for about 19 seconds
A similar effect to the Lemon Party pill
Type: Active
Recharge Time: 4 rooms
Item Pool: Item Room
Spirit Sword
ItemID: 579
"Divine blade"
Quality: 3
Your tears are replaced with a sword which can be swung to deal damage (Damage * 3 + Base Damage)
Holding the fire button charges a spin attack (Damage * 8 + 10). The charge time is based on your tears stat.
While at full red health you also shoot a projectile across the room with each swing, dealing your current Damage + 2 (similar to the Master Sword in Zelda)
Unlock this item by defeating challenge #39 (Isaac's Awakening)
Type: Passive, Tear Modifier
Item Pool: Angel Room
Red Key
ItemID: 580
"Explore the other side"
Quality: 3
While held, a red outline of a door will appear on certain walls. Using the Red Key near it will spawn a red room
This room will randomly choose from many types, including (but not limited to) any regular room from that floor, treasure rooms, curse rooms, devil rooms, angel rooms, I AM ERROR rooms and more
In rooms with multiple door outlines, the closest one will be opened
Attempting to create a room outside the maximum boundary (13 x 13 rooms) of the map will take you to an I AM ERROR room. You can't use the Red Key to leave this room
The Red Key can be used to open the secret room in the Home floor, which is the method for unlocking alternative 'Tainted' characters
Unlock this item by opening Mom's Box in the Home floor
Type: Active
Recharge Time: 4 rooms
Item Pool: Secret Room, Red Chest, Curse Room, Key Beggar, Mom's Chest
Psy Fly
ItemID: 581
"Flamboyant protector"
Quality: 4
Gives Isaac an orbital fly, that will rapidly charge around and deflect any incoming tears that would hit Isaac.
It isn't 100% effective but the effect is very strong and will deflect most shots under a bullet hell situation.
Deflected tears turn into homing tears and fire back at enemies, dealing 2 damage.
After reflecting a certain number of projectiles, Psy Fly enters a brief cooldown period
Counts as 1 of 3 fly items needed towards the Beelzebub transformation.
Type: Passive, Familiar
Item Pool: Item Room, Key Beggar
Wavy Cap
ItemID: 582
"Tears up. A mind changing experience!"
Quality: 1
Every time you use Wavy Cap, it gives +0.75 Tears Up and -0.03 Speed Down
Also when used, this item will distort the screen and sound slightly, stacking every time you use it
All of these effects stack for the rest of the floor, meaning if used too many times the screen will be distorted so much it becomes unplayable
Each room you clear removes one use worth of effect - reducing the screen distortion slightly and giving +0.06 Speed Up and -0.3 Tears Down
This item was called Black Mushroom in Antibirth
Counts as 1 of 3 mushroom items needed towards the Fun Guy transformation.
Type: Active
Recharge Time: Starts at 1 second, increasing by every time you use it. After 10 uses it stops auto recharging.
Item Pool: Secret Room
Rocket in a Jar
ItemID: 583
"Rocket propulsion +5 bombs"
Quality: 2
+5 Bombs
Placing a bomb while pressing a fire button will fire an explosive rocket in that direction
Placing a bomb while standing still will place a regular bomb
Type: Passive
Item Pool: Item Room, Bomb Beggar
Book of Virtues
ItemID: 584
"Spiritual companionship"
Quality: 3
Upon use, spawns a flame familiar that fires spectral tears and deals contact damage to enemies. After taking two hits, the fire will be extinguished
The Book can be held at the same time as another active item. When used, this will combine with your other active item, creating a unique flame and possibly giving special effects
The recharge time of this item is based on your 2nd active item, otherwise it's 4 rooms
While held, guarantees the first Devil/Angel Room encountered to be an Angel Room, and increases the overall chance of getting one
A maximum of 16 flames can be active at one time around Isaac
Counts as 1 of 3 book items needed towards the Bookworm transformation
Unlock this item by defeating Isaac as Bethany
Type: Active/Passive Item
Recharge Time: Varies
Item Pool: Angel Room, Library
Alabaster Box
ItemID: 585
"A sacred offering"
Quality: 2
A single use active item that will spawn 3 soul hearts and 2 items from the Angel Room pool
Starts fully uncharged and gains charges only through picking up soul and black. (6 full hearts to fully charge)
Unless fully charged, hearts picked up are consumed by the Alabaster Box, instead of being added to your life total
If a devil deal was already taken this run, it spawns 2 soul hearts and 1 Angel Room item instead.
Picking up Bone Hearts while at 12 hearts will remove charges from the Box
Unlock this item by defeating The Lamb as Bethany
Type: Active
Recharge Time: 12 charges (one time use)
Item Pool: Shop
The Stairway
ItemID: 586
"Stairway to heaven"
Quality: 3
Spawns a ladder in the starting room of all future floors, which leads to an Angel Room
Angel rooms accessed by The Stairway are different - They sell angel room items and soul hearts for money, similar to the Shop
Pedestal items cost 15c, all other items (eternal/soul hearts, keys and holy cards) cost 5c. Sales can be randomly applied just like regular shops
The ladder disappears after leaving the starting room, even if you haven't used it yet
In Antibirth this was called Jacob's Ladder, which had to be renamed as Afterbirth+ already had an item with this name
Unlock this item by defeating Isaac as Jacob & Esau
Type: Passive
Item Pool: Angel Room
Sol
ItemID: 588
"Radiant victory"
Quality: 2
Permanently shows the location of the boss room on the map
After defeating the shown boss fight, this item will activate a use of the Sun card (full heal and map reveal), fully recharge your active item, remove curses from the floor, gives +3 Damage Up and +1 Luck up for the rest of the floor
Only available inside a Planetarium - a room that has a base 1% chance to appear, which increases by +20% every time you skip an Item Room (Must not enter to count as skipped)
In The Void floor it shows a random boss room, which isn't necessarily Delirium's room
Type: Passive
Item Pool: Planetarium
Luna
ItemID: 589
"More secrets"
Quality: 2
Adds one extra secret room and one extra super secret room to each floor
Each secret room contains a beam of light, that gives half a soul heart, and a Tears Up for the rest of the floor. These stack with multiple secret rooms - The first one gives +1.00 Tears Up, then all future ones give +0.5.
Reveals the location of one secret room on the minimap.
Only available inside a Planetarium - a room that has a base 1% chance to appear, which increases by +20% every time you skip an Item Room (Must not enter to count as skipped)
Type: Passive
Item Pool: Planetarium
Mercurius
ItemID: 590
"Speed up + you feel elusive"
Quality: 3
+0.40 Speed Up
Doors remain open when entering a room with enemies in it. This means you can leave rooms before defeating the enemies inside
Doesn't open locked doors, or the door that leads to the Boss Room
Only available inside a Planetarium - a room that has a base 1% chance to appear, which increases by +20% every time you skip an Item Room (Must not enter to count as skipped)
Type: Passive
Item Pool: Planetarium
Venus
ItemID: 591
"HP up + you feel pretty"
Quality: 2
+1 HP Up
Heals one red heart container when picked up
This item causes nearby enemies to be affected by the charm effect, causing them to attack other nearby enemies
The charm effect will wear off very quicky when enemies move away from Isaac
Only available inside a Planetarium - a room that has a base 1% chance to appear, which increases by +20% every time you skip an Item Room (Must not enter to count as skipped)
Type: Passive
Item Pool: Planetarium
Terra
ItemID: 592
"Born to rock"
Quality: 3
This item causes your tears to become rocks, which have increased knockback and can break other rocks and objects. This includes key blocks and secret room doors
+1.0 Damage Up, but each rock tear has a random damage modifier that can go up or down (x0.5 to x2)
Only available inside a Planetarium - a room that has a base 1% chance to appear, which increases by +20% every time you skip an Item Room (Must not enter to count as skipped)
Type: Passive, Tear Modifier
Item Pool: Planetarium
Mars
ItemID: 593
"Double tap dash"
Quality: 2
Allows Isaac to charge by double tapping the same direction, dealing damage to any enemies caught
You are invincible while charging (doesn't include self-damage like Blood Donation machines)
Can be used multiple times per room
The dash deals x4 your current tear damage + 8
Doesn't have to be in a straight line, you can hold another button to curve it
Has a 3 second cooldown before it can be used again
Only available inside a Planetarium - a room that has a base 1% chance to appear, which increases by +20% every time you skip an Item Room (Must not enter to count as skipped)
Type: Passive
Item Pool: Planetarium
Jupiter
ItemID: 594
"You're a gas giant!"
Quality: 2
+2 HP Up (only half a heart is filled)
-0.3 Speed Down
While not moving your speed rapidly increases up to a bonus of +0.5
While you have this +0.5 bonus, moving will cause Isaac to fart around the room, spawning poison gas clouds
The farts stop spawning once you reach your regular movement speed
Poison deals damage equal to half your tears per tick
Isaac is immune to Poison from enemies, such as Gasbag
Only available inside a Planetarium - a room that has a base 1% chance to appear, which increases by +20% every time you skip an Item Room (Must not enter to count as skipped)
Type: Passive
Item Pool: Planetarium
Saturnus
ItemID: 595
"Ring of tears"
Quality: 2
Gives you a wide circle halo which grants 7 orbital tears upon entering a new room
The tears orbit for 13 seconds before dropping off
Has a chance to absorb any enemy tears and add them to the orbiting tears. They can be used to damage enemies
Saturnus tears can't break objects such as poop and TNT barrels
Only available inside a Planetarium - a room that has a base 1% chance to appear, which increases by +20% every time you skip an Item Room (Must not enter to count as skipped)
Type: Passive
Item Pool: Planetarium
Uranus
ItemID: 596
"Ice tears"
Quality: 3
Isaac now shoots ice tears that slow enemies. Enemies that are killed by the ice tears will become frozen
Frozen enemies never unfreeze and are considered dead by the game. Kicking a frozen enemy will push it into the wall, where it shatters and fires ice shards everywhere (these can then freeze other enemies)
Only available inside a Planetarium - a room that has a base 1% chance to appear, which increases by +20% every time you skip an Item Room (Must not enter to count as skipped)
Type: Passive
Item Pool: Planetarium
Neptunus
ItemID: 597
"Open the floodgates"
Quality: 3
Isaac will now automatically charge up tears, allowing you to store them up and fire them rapidly for a short time
Any time you aren't firing tears, the charge bar will start filling up, for up to 3 seconds. Holding down the fire button again will quickly release all stored teared
The charge time and max tears stored scales with your current tears stat
Only available inside a Planetarium - a room that has a base 1% chance to appear, which increases by +20% every time you skip an Item Room (Must not enter to count as skipped)
Type: Passive, Tear Modifier
Item Pool: Planetarium
Pluto
ItemID: 598
"Size down"
Quality: 3
+0.7 Tears Up
Greatly reduce Isaac's size, to an extent where some enemy tears will now travel straight over him without dealing damage if they are high off the ground. Tears can still hit Isaac if gravity applies for too long
Allows Isaac to squeeze between some objects
Only available inside a Planetarium - a room that has a base 1% chance to appear, which increases by +20% every time you skip an Item Room (Must not enter to count as skipped)
Type: Passive
Item Pool: Planetarium
Voodoo Head
ItemID: 599
"Extra curse rooms"
Quality: 2
This item has a chance to spawn an additional curse room on each future floor
Causes a penny to spawn in all future Curse Rooms
Improves curse room layouts and rewards
Type: Passive
Item Pool: Shop, Crane Game
Eye Drops
ItemID: 600
"Tears up"
Quality: 3
Tears fired from your left eye gain roughly +28% fire rate increase
Causes your tears to be fired at staggered rates
Type: Passive
Item Pool: Boss Room
Act of Contrition
ItemID: 601
"Tears up, you feel forgiven"
Quality: 3
+1 Eternal Heart
+0.7 Tears Up
Allows Angel Rooms to appears even if a Devil deal has been taken before
Type: Passive
Item Pool: Angel Room
Member Card
ItemID: 602
"Exclusive access!"
Quality: 2
All shops now contain a trapdoor with a ladder, which leads down to a special shop
The special shop contains various consumables and items at a higher price from the Devil/Angel room, Boss room and Secret room pools.
Items cost 15-30c, trinkets cost 15c, cards/runes cost 6-8c, black/bone hearts 8c, eternal hearts 15c, rotten hearts 5c
Unlock this item by spending 40+ coins in the same shop
Type: Passive
Item Pool: Shop
Battery Pack
ItemID: 603
"Instant energy!"
Quality: 0
When picked up, this item fully recharges your currently held active item and drops between 2-4 battery pickups. These can be smaller or big batteries
Type: Passive
Item Pool: Shop, Battery Beggar
Mom's Bracelet
ItemID: 604
"Mother's strength"
Quality: 1
Upon use, Mom's Bracelet allows you to grab objects in the room and throw them, damaging any enemies which are hit for 40 damage
Most objects can be thrown including pots, rocks, poops, tnt etc
Pressing the activate button again will drop the object where you stand, which doesn't consume a charge of use
Allows you to remove the skull on top of Host enemies, turning them into the red version
Counts as 1 of 3 mom items needed towards the Mom transformation
Type: Active
Recharge Time: 1 second
Item Pool: Shop, Crane Game, Mom's Chest
The Scooper
ItemID: 605
"Plop!"
Quality: 1
When used, this item spawns a Peeper familiar for the current room, which deals 12 contact damage per tick to enemies and leaves red creep in its path
Using this item removes Isaac's right eye, causing tears from this eye to deal x1.5 your normal tear damage
Using it more than once in the same room will spawn multiple Peeper familiars
Type: Active
Recharge Time: 3 rooms
Item Pool: Item Room
Ocular Rift
ItemID: 606
"Stare into the abyss"
Quality: 3
Fired tears now have a chance to summon a rift when they land on the ground
The spawned rift sucks in enemies, projectiles and pickups and deals damage to enemies caught inside for 2 seconds
The chance to fire the rift tear can improve based on your luck stat. At +0 Luck theres a ~2.5% chance for this effect to activate
The size of the rift scales with your tear damage
Rifts deal half your damage per tick
In Antibirth this item was called Oculus Rift
Type: Passive
Item Pool: Devil Room
Boiled Baby
ItemID: 607
"Messy friend"
Quality: 1
A familiar boil that randomly fires bursts of tears, similar to the Boil enemy
Tears either deal 5.3 or 3.5 damage
Counts as 1 of 3 familiar items needed towards the Conjoined transformation.
Type: Passive, Familiar
Item Pool: Item Room
Freezer Baby
ItemID: 608
"Iced iced baby"
Quality: 2
A familiar baby that fires tears which have a chance to freeze or petrify enemies
Frozen enemies never unfreeze and are considered dead by the game. Kicking a frozen enemy will push it into the wall, where it shatters and fires ice shards everywhere (these can then freeze other enemies)
Counts as 1 of 3 familiar items needed towards the Conjoined transformation
Type: Passive, Familiar
Item Pool: Item Room
Eternal D6
ItemID: 609
"???"
Quality: 3
When used, rerolls all items in the room into another random item from the current room's item pool, however the item also has a 30% chance to disappear
The chance associated with this item does NOT scale with your Luck stat - it's always 30%
In the game files this item is called 'Florians Dice', which is a reference to the Eternal update for the original Binding of Isaac game, which changed the D6 to act as this item does
Unlock this item by defeating Mother in the Corpse II as ???
Type: Active
Recharge Time: 2 rooms
Item Pool: Item Room, Secret Room, Crane Game
Bird Cage
ItemID: 610
"Fat buddy"
Quality: 1
Taking damage for the first time in a room spawns a familiar which targets an enemy and jumps on them, releasing a rock wave outwards
For the remainder of the room the familiar then continues to attack enemies similar to the Dead Bird item dealing 3 contact damage per tick
Deals 45 damage to enemies it lands on. The rock wave deals 10 damage.
Unlock this item by defeating Mother in the Corpse II as Eve
Type: Passive
Item Pool: Item Room
Larynx
ItemID: 611
"Hear my pain"
Quality: 2
When used, this item does a shout-type attack, with its effect increasing in damage and size the more charges you have
Larynx can be used with any number of charges. At 1 charge it deals 48 damage to any enemies close to Isaac. At the full 12 charges Isaac does a massive shout, dealing 356 damage to all enemies on the screen
Larynx gains 1 charge every time you take damage (also charges as normal)
Unlock this item by defeating The Beast as Tainted Samson
Type: Active
Recharge Time: 12 rooms (Can be used with partial charges)
Item Pool: Item Room, Greed Mode Item Room
Lost Soul
ItemID: 612
"Protect him"
Quality: 2
This item gives you a familiar version of The Lost character which dies instantly upon hit
If the familiar survives an entire floor you get one of: 3 soul hearts, 2 eternal hearts or a random item/angel room item
Regenerates at the start of each floor if dead
Unlock this item by defeating Mother in the Corpse II as The Lost
Type: Passive, Familiar
Item Pool: Item Room, Secret Room
Blood Bombs
ItemID: 614
"Bloody blast + HP up"
Quality: 2
+1 HP Up
Restores 5 empty red heart containers
Bombs now spawn a puddle of red creep upon explosion, dealing 2 damage per tick to enemies touching it
While at 0 bombs, you can also place further bombs now at the cost of 1/2 of a heart (kills The Lost if used like this). Placing a bomb this way will not affect your devil/angel room chances
Type: Passive
Item Pool: Item Room
Lil Dumpy
ItemID: 615
"Puffy buddy"
Quality: 3
Lil Dumpy follows Isaac and produces a Butter Bean fart when a projectile or enemy is about to hit Isaac, pushing the enemy back and preventing the damage
After it farts, it flies away, stops following Isaac and has to be picked up again before it will follow again
He also has a second larger detection radius that can randomly trigger from enemy projectiles
The effect only works if Lil Dumpy is following and near Isaac
Type: Passive
Item Pool: Item Room
Bird's Eye
ItemID: 616
"It burns"
Quality: 3
You have a chance alongside each tear to shoot a red flame, which deals damage to enemies that come in contact with it
Damage starts at x4 your current tear damage, and scales down each time an enemy touches the fire
The chance to create a fire scales with your Luck stat, at +11 Luck you have a 50% chance to shoot one
The flames from this item can destroy shopkeepers, which is handy since doing this once per floor increases your devil/angel room chances slightly
Type: Passive
Item Pool: Item Room
Lodestone
ItemID: 617
"Magnetizing tears"
Quality: 3
Tears now have a chance to cause enemies to be magnetized
Magnetized enemies attract other enemies, tears (including Isaac's) and enemy projectiles, causing them to be pulled in towards them
Enemy tears that get pulled into other enemies will hurt them
Type: Passive
Item Pool: Item Room, Crane Game
Rotten Tomato
ItemID: 618
"Delicious!"
Quality: 2
You have a chance to fire a tear that marks enemies red and slow them
Marked enemies will be attacked by other enemies either until it is killed or it kills all the other enemies attacking it
Chance to fire a marking tear scales with your luck stat
Type: Passive
Item Pool: Item Room, Rotten Beggar
Birthright
ItemID: 619
"???"
Quality: 3
This item has a different effect for each character. See next icon for Tainted character effects
Isaac - All new pedestal items cycle through two options
Maggy - +1 HP up. Increases the maximum heart limit to 18.
Cain - +1 Luck. All floors guaranteed to have an Arcade except the Chest & Dark Room floors
Judas - Gives a passive Book of Belial item similar to Book of Virtues. Using active items gives a damage up that scales with the charge time
??? - Every HP upgrade is now worth 2 soul hearts. Health down effects still only remove 1 heart
Eve - Whore of Babylon and Dead Bird effects are always active
Samson - Bloody Lust can gain 4 more damage boosts, for a new max total of +14 Damage
Azazel - His beam becomes much wider, no effect on damage
Lazarus - Every time Lazarus dies, gives +21.6 temporary Damage Up, gradually fading over 1 minute.
Eden - Spawns 3 items from any pools, you can only take 1
The Lost - Useless items like HP upgrades, spectral tears or flight are removed from the item pools
Lilith - Causes all your offensive familiars to stack tightly infront of Lilith for more controlled damage
Keeper - +1 HP up. Increases HP cap by 1
Apollyon - Void has a chance to spawn a previously destroyed item as well. More items consumed = more chance for this effect
The Forgotten - Your Soul is now unchained and free to move.
Bethany - Activating an item using soul charges is sometimes free
Jacob & Esau - The character who picks up Birthright gains copies of three of the other character's passive items
Unlock this item by defeating ??? as Jacob & Esau
Type: Passive
Item Pool: Shop
Birthright (Tainted)
ItemID: 619
"???"
Quality: 3
This item has a different effect for each character. See previous icon for normal character effects
Tainted Isaac - Adds 4 more spaces for passive items
Tainted Maggy - Adds 1 extra real heart container that doesn't deplete
Tainted Cain - Doubles picks dropped when touching an item
Tainted Judas - Increases the range in which Dark Arts hits enemies and tears
Tainted ??? - Allows you to hold up to 29 poops
Tainted Eve - Clots created only from red hearts spawn a heart that disappears after 2 seconds when they die
Tainted Samson - Chaining kills adds 3 seconds to the Berserk timer instead of 1
Tainted Azazel - Doubles his sneeze size
Tainted Lazarus - The inactive character moves alongside you like Esau. Can fire tears but is immune to damage
Tainted Eden - Items taken before Birthright no longer get rerolled when taking damage
Tainted Lost - Grants an extra life. Deals 200 damage to nearby enemies when reviving
Tainted Lilith - All familiars now attach to her Umbilical cord like the Gello item
Tainted Keeper - Nearby coins dropped by enemies move towards you quickly
Tainted Apollyon - Holding the fire button causes locusts to stay near enemies and damage them instead of returning
Tainted Forgotten - Grants the Recall ability. When used, it retrieves the Forgotten skull, causing it to shoot back into your arms
Tainted Bethany - Spawns four random item wisps of high quality with significantly higher HP than normal
Tainted Jacob - Dark Esau splits into 2. Both charge at the same time and using Anima Sola chains both in the same spot
Unlock this item by defeating ??? as Jacob & Esau
Type: Passive
Item Pool: Shop
Red Stew
ItemID: 621
"Full HP + temporary DMG up"
Quality: 2
Fully heals all red heart containers
Significantly increases damage by +21.6, however the damage boost wears off slowly over time at a rate of roughly -0.04 per second
Every enemy you kill adds +0.02 Damage to the timed effect of Red Stew
Unlock this item by defeating Satan as Jacob & Esau
Type: Passive
Item Pool: Shop, Ultra Secret Room
Genesis
ItemID: 622
"In the beginning"
Quality: 3
When used, removes all your passive items and teleports you to Isaac's Bedroom
For every passive item removed, you are given a choice of 3 random pedestal items from any item pool. Essentially you are rerolling all your items, but each new item you get to choose between 3 random options
The bedroom also contains a random trinket, 2 chests, 2 sacks and Isaac's bed, which can be used to full heal your red heart health
The only way to exit Isaac's bedroom is teleporting out or via the trapdoor, which takes you to the next floor. This will deviate you from the alt path if you are currently on it
Since this item resets your stats, this item can remove Broken Hearts
Unlock this item by defeating Greedier Mode as Jacob & Esau
Type: Active
Recharge Time: One time use
Item Pool: Angel Room, Greed Mode Angel Room
Sharp Key
ItemID: 623
"Open your enemies"
Quality: 1
+5 Keys
Upon use, allows you to consume 1 key and fire it at an enemy, piercing enemies and dealing significant damage
The damage done by the key projectile pierces through enemies and scales with your damage upgrades (x5 damage + 30)
Keys fired by this item can open locked doors/chests, secret rooms and destroy objects in the room, such as rocks
Cannot be used if you don't have any keys
Enemies killed by Sharp Key have a ~10% chance to spawn random items that appear in a chests. This can be anything that would normally drop from a chest including pedestal items
Type: Active
Recharge Time: Instant
Item Pool: Shop
Booster Pack
ItemID: 624
"Collect them all!"
Quality: 1
Spawns 5 random cards
Type: Passive
Item Pool: Boss Room, Shop
Mega Mush
ItemID: 625
"I'm a big boy now!"
Quality: 4
When used, this item causes Isaac to become humongous for 30 seconds
While huge, Isaac is invincible and can crush objects, doors and enemies
For the duration of the effect this gives you a x4 Damage Multiplier and +2.0 Range Up, but your rate of fire goes way down
Deals significant contact damage to enemies while active (1600 dps).
Counts as 1 of 3 mushroom items needed towards the Fun Guy transformation.
Unlock this item by getting all hard mode completion marks for the 17 non-tainted characters
Type: Active
Recharge Time: 12 rooms
Item Pool: Item Room
Knife Piece 1
ItemID: 626
"???"
Quality: 0
Combine with Knife Piece 2 to create a Knife which can be fired across the room, dealing 25 damage to any enemies it comes into contact with
In the Downpour/Dross II, you will find a white flame somewhere, and a room with a mirror in it. Touching the white flame temporarily turns you into The Lost, but allows you to walk through the mirror into a mirrored version of this floor. You have the Holy Mantle effect to prevent one hit per room, but taking another hit will kill you. The Knife Piece 1 is located in the Item Room in the mirrored area. Returning back through the mirror door returns you back to normal again
If you haven't unlocked Holy Mantle for The Lost yet, you won't gain the effect after touching a white fire so be careful!
The mirrored floor rooms have respawned enemies, and allows you to optionally fight the Boss a second time for an extra item
When combined with Knife Piece 2, can be used to stab the fleshy door in the Mausoleum II, which then leads to the Corpse floor and the Mother boss
Type: Passive
Item Pool: None (see above)
Knife Piece 2
ItemID: 627
"???"
Quality: 0
Combine with Knife Piece 1 to create a Knife which can be fired across the room, dealing 25 damage to any enemies it comes into contact with
In the Mines/Ashpit II, there's a room with a minecart and a broken track. Pressing 3 yellow buttons on the floor causes the minecart to be rideable. Following the path takes you to an abandoned mineshaft, which leads you to a pedestal with the Knife Piece. Taking it will cause Mom's Shadow to spawn and chase you. You must make it back through the path solving a few bomb puzzles while avoiding her, to get back to the regular floor. All your items and consumables are temporarily removed while in the abandoned mine
The room to access Knife Piece 2 only appears if you have Knife Piece 1 already
You can skip pressing the 3 yellow buttons if you have the ability to fly and have 2 bombs to force open the door
When combined with Knife Piece 1, can be used to stab the fleshy door in the Mausoleum II, which then leads to the Corpse floor and the Mother boss
Type: Passive
Item Pool: None (see above)
Death Certificate
ItemID: 628
"Where am I?"
Quality: 4
This is a one time use item that teleports you to an alternate floor, which contains every single item in the game
The items are spread between several different rooms all on pedestals. You may take only one of the items, before being teleported back to where you were
It's literally every item, that includes items not in item pools like Knife Pieces
Unlock this item by completing every post-it note for every character, including the Tainted characters
Type: Active
Recharge Time: 1 time use
Item Pool: Secret Room
Bot Fly
ItemID: 629
"Defense drone"
Quality: 3
Gives you a robot fly familar that orbits around Isaac and fires shielded tears at incoming projectiles
Deals contact damage to enemies it touches
Counts as 1 of 3 fly items needed towards the Beelzebub transformation
Type: Passive, Familiar
Item Pool: Item Room, Key Beggar, Crane Game
Meat Cleaver
ItemID: 631
"Slice but no dice"
Quality: 1
When used, the Meat Cleaver will split all enemies in the room into 2 smaller versions with ~40% health each
For enemies that have multiple parts to them (e.g. Larry Jr.) it will split them into 2 smaller enemies with half the number of sections they used to have
If the enemy normally has a mechanic that splits it (e.g. Teratoma, Envy) then Meat Cleaver will deal a lot of damage and trigger the splitting effect
If the split enemy has low enough health, it will just die instead of splitting
Doesn't work on end-game bosses except Delirium, where it will deal a chunk of damage and spawn a 2nd Delirium to deal with
Unlock this item by defeating Mother in the Corpse II as Isaac
Type: Active
Recharge Time: 2 rooms
Item Pool: Item Room
Evil Charm
ItemID: 632
"Luck up + you feel protected"
Quality: 2
+2 Luck Up
You no longer take damage from poison/toxic gas/burn effects, and become immune to fear/confusion
Type: Passive
Item Pool: Secret Room
Dogma
ItemID: 633
"Ascended"
Quality: 3
This item isn't available in any item pools - you are automatically given it after defeating Dogma, just before The Beast sequence
+0.1 Speed Up
+2.0 Damage Up
Grants you the ability to fly
Grants a one-time use of the Holy Mantle effect
On normal mode this grants The Wafer effect, causing all damage to do a maximum of half a heart each time
Sets your health to 6 hearts if you have fewer than 6. This will heal red hearts and then give soul hearts up to a total of 6. This doesn't work with The Lost characters
Type: Passive
Item Pool: None
Purgatory
ItemID: 634
"Help from beyond"
Quality: 2
While in a room with enemies, red cracks will appear on the floor in random locations
Walking over the crack spawns a white soul familiar, that launches itself into the nearest enemy, exploding and dealing double your tear damage to everything near it
Cracks will keep appearing but only one can exist in the room at a time
Unlock this item by defeating challenge #38 (Baptism by Fire)
Type: Passive
Item Pool: Devil Room, Angel Room
Stitches
ItemID: 635
"Bait and switch"
Quality: 1
While held, this item spawns a familiar that can be moved around using the arrow keys and deals 1.5 damage per tick to any enemies it touches
When activated, you teleport, swapping places with wherever Stitches was positioned
Teleporting next to fires will extinguish them (including blue fires) and on top of shopkeepers will destroy them (gives +10% devil/angel room chance as normal)
If used while stitches is on top of an enemy, it can be used to telefrag enemies, dealing x3.5 your damage + 40
Can be used to enter/exit Curse Rooms for free by teleporting infront of the door while holding the direction key to move in immediately. Also works for opening Spiked Chests and Mimic Chests without taking damage
Type: Active, Familiar
Recharge Time: 3 seconds
Item Pool: Item Room
R Key
ItemID: 636
"Time to start over"
Quality: 4
When used, this item restarts the game and places you back on the first floor with all your currently collected items, similar to doing a Victory Lap
The game timer does not reset
Allows angel rooms to be found in the new run if a devil deal was taken in the first run
In Greed Mode and while playing as Tainted Keeper, this item costs 99 coins instead of 15
When used in the backwards path after picking up Dad's Note, R key will skip you to the Basement 1 version of this path, which leads directly to the Home floor. This may cause you to skip floors where you left a trinket to spawn a Cracked Key.
Donation machines become fixed if they were jammed before using the R Key
Type: Active
Recharge Time: Single use
Item Pool: Secret Room
Knockout Drops
ItemID: 637
"They pack a punch!"
Quality: 3
Isaac now has a chance to fire a fist instead of normal tears, which have a much higher knockback effect and confuse enemies for a few seconds
Enemies that are knocked back will take 10 damage and knock back any enemy they are knocked into, dealing damage to them as well
Type: Passive
Item Pool: Item Room
Eraser
ItemID: 638
"Erase thy enemy"
Quality: 2
An active item that allows you to throw an eraser at any enemy, which will kill it and prevent it from appearing for the rest of the run
Enemies that are erased create a puff of smoke instead of spawning
Works on bosses, except it doesn't kill them it just deals 15 damage
Can only be used once per floor - batteries also cannot be used to recharge it to bypass this restriction
The first use will raise it above your head, then by pressing the fire button it will be thrown in that direction
Type: Active
Recharge Time: 1 room (Can only be used once per floor)
Item Pool: Shop, Crane Game
Yuck Heart
ItemID: 639
"Gross!"
Quality: 1
When used, this item will give you +1 Rotten Heart
Rotten Hearts act as red hearts and each one you currently have spawns 2 blue flies upon successfully clearing a room
Unlock this item by defeating Mother in the Corpse II as Maggy
Type: Active
Recharge Time: 4 rooms
Item Pool: Item Room, Rotten Beggar
Urn of Souls
ItemID: 640
"Unleash their sorrow"
Quality: 3
Enemies now create a soul upon death, which is automatically sucked into the Urn giving it +1 charge. Mini-bosses and bosses create 2-3 souls
When activated, the urn can be fired as a high damage flamethrower in any direction
A charge is consumed roughly every 0.5 seconds of use
Multi-part enemies such as Envy or Teratoma create a soul per each part killed
A maximum of 20 souls can be held in the urn at one time
Unlock this item by beating Satan as Bethany
Type: Active
Recharge Time: None (see above)
Item Pool: Angel Room
Akeldama
ItemID: 641
"Spill your guts"
Quality: 2
With each shot fired, another bloody tear will spawn behind Isaac
Spawning multiple tears will form a trail of tears that follow Isaac as he moves, bursting and dealing damage upon contact with enemies
The effect from this item will only work while in a hostile room that contains at least 1 enemy
Unlock this item by defeating Mother in the Corpse II as Judas
Type: Passive
Item Pool: Item Room
Magic Skin
ItemID: 642
"All your desires fulfilled"
Quality: 2
Upon use, this item consumes 1 heart container or 2 soul hearts and spawns one item pedestal from the current room's pool
Every use gives a broken heart, meaning that slot is permanently broken and the maximum health limit is reduced by 1 for the rest of the run
If Isaac has 12 broken hearts, he dies instantly (this also applies to The Lost despite having no health)
Magic Skin will continue to appear after finding it once if you are not still holding it - the chance for it to replace an item is 1 Ć· (12 - number of times used) up to a maximum of 50%
Broken hearts are empty heart containers that cannot be removed or refilled and will override other types of hearts when you reach 12 total. Replacing all 12 containers with broken hearts will kill you instantly. The only way to remove broken hearts is by donating to a Confessional Machine
Unlock this item by defeating Mother in the Corpse II as Jacob & Esau
Type: Active
Recharge Time: 6 rooms
Item Pool: Shop, Red Chest, Curse Room
Revelation
ItemID: 643
"Awaken your faith"
Quality: 4
+2 Soul Hearts
Grants you the ability to fly
Holding the fire button charges up a light beam attack similar to Brimstone
The light beam deals damage equal to your current tear damage per tick to any enemies touching it
Counts as 1 of 3 angel items needed towards the Seraphim transformation.
Unlock this item by defeating Mother in the Corpse II as Bethany
Type: Passive
Item Pool: Angel Room
Consolation Prize
ItemID: 644
"+1 to lowest stat"
Quality: 1
When picked up, this item gives you a stat increase, based on which is currently the lowest. Stat options are: +1.0 Damage, +0.6 Tears, +0.2 Speed, +5.25 Range
Also drops either a bomb, a key or 3 coins on the ground. This is decided by whatever you have the least of. Keys and bombs are equal to 3 coins for deciding which to give
Type: Passive
Item Pool: Boss Room, Golden Chest, Crane Game
Tinytoma
ItemID: 645
"Itching for revenge"
Quality: 1
Grants a large orbital that rotates around Isaac
When the orbital takes a few hits, they split into two smaller ones
After the smaller orbitals take another hit, they explode into 2 blue spiders
This item will respawn after a period of time
Unlock this item by defeating Mother in the Corpse II as Lazarus
Type: Passive, Familiar
Item Pool: Item Room
Brimstone Bombs
ItemID: 646
"Demon blast +5 bombs"
Quality: 2
+5 Bombs
Your bombs now explode and fire 4 Brimstone lasers in all cardinal directions
Each brimstone laser deals 8 damage per tick for 13 total hits
Unlock this item by killing Hornfel before he can escape after breaking his minecart
Type: Passive
Item Pool: Devil Room, Bomb Beggar, Greed Mode Devil Room
4.5 Volt
ItemID: 647
"Beat the juice out of them!"
Quality: 2
Active items no longer charge up as normal from clearing rooms
Enemies taking damage now charges your item instead. This includes damage you deal, and environmental damage they take e.g. from Fireplaces
60 damage dealt = 1 charge
Type: Passive
Item Pool: Shop, Battery Beggar
Fruity Plum
ItemID: 649
"Bouncy friend"
Quality: 1
Gives you a familiar which is a smaller version of the Plum boss, which sprays tears and propels itself around the room
Deals 2 contact damage per tick to enemies, and the tears deal 3 damage each
Deals contact damage to any enemies it runs into
Counts as 1 of 3 fly items needed towards the Beelzebub transformation.
Unlock this item by beating Baby Plum 10 times
Type: Passive, Familiar
Item Pool: Item Room, Key Beggar
Plum Flute
ItemID: 650
"Play time!"
Quality: 1
When used, this item calls a friendly version of the Plum boss to fight for you for 10 seconds
It will jump to the nearest enemy, slam on the ground and fire tears around it, then propel itself around the room, dealing contact damage to any enemies it touches before disappearing
It's possible to get a guaranteed spawn of this item by encountering the Baby Plum boss and not damaging her. After a minute or so of not hurting her she will fly away and spawn Plum Flute
Counts as 1 of 3 fly items needed towards the Beelzebub transformation.
Unlock this item by allowing Baby Plum to escape instead of killing her
Type: Active
Recharge Time: 4 rooms
Item Pool: Item Room
Star of Bethlehem
ItemID: 651
"Follow the light"
Quality: 3
Spawns a star with a white aura around it, that floats very slowly through each room on the floor, making its way towards the boss room
While standing inside the aura, you gain a big Tears Up (x2.5 fire rate), Damage Up (damage * 1.2 + 1) and homing tears
The star continues to make its way through the floor, even if you aren't in the same room as it, moving faster if you are a long distance ahead of it
On The Void floor, it will move towards the boss room containing Delirium
Doesn't travel into the Hush or Mega Satan boss room
It may travel through secret/curse rooms on its route to the boss room
Counts as 1 of 3 astrology items needed in the same run to unlock Planetariums
Unlock this item by defeating Delirium as Bethany
Type: Passive, Familiar
Item Pool: Angel Room
Cube Baby
ItemID: 652
"Kick it!"
Quality: 1
Gives you a baby in an ice cube, which can be kicked around the room by walking into it
Enemies take damage from Cube Baby depending on how fast it was travelling when it hit them. Having a higher movement speed allows you to kick it harder
Enemies hit by the cube while moving have a high chance to become frozen. Frozen enemies never unfreeze and are considered dead by the game. Kicking a frozen enemy will push it into the wall, where it shatters and fires ice shards everywhere (these can then freeze other enemies)
Enemies touching the cube while it's not moving or moving slowly will become slowed for a few seconds, and take a small amount of damage
Cube Baby and enemies frozen will block enemy shots
Cube Baby can be launched across the room if you have a melee weapon
Counts as 1 of 3 familiar items needed towards the Conjoined transformation.
Type: Passive, Familiar
Item Pool: Item Room
Vade Retro
ItemID: 653
"Begone!"
Quality: 2
Enemies that die now spawn a red ghost, that floats in place of where the enemy died
Activating the item causes all red ghosts in the room to explode, dealing damage to any enemies near them
The explosion doesn't deal damage to Isaac
Damage dealt by each ghost is 3 + 0.04x the HP of the enemy it spawned from
Larger enemies such as minibosses will spawn a larger red ghost that causes 3 explosions
The red ghosts can be moved around slightly by firing tears through them
Using the item will instantly kill any enemy or boss that has the 'ghost' tag and is at 50% or less HP. Enemies include Candler, Lil' Haunt, Polty, Red Ghost, Wizoob and The Forsaken, The Haunt, The Heretic and The Rainmaker bosses. This effect also works on Delirium if it is currently transformed into The Haunt while below half health
Unlock this item by defeating Greedier mode as Bethany
Type: Active
Recharge Time: Instant
Item Pool: Angel Room
False PHD
ItemID: 654
"Worse pills + evil up"
Quality: 2
Identified all pills on pickup, and converts them to their worse counterparts (e.g. Stat Up becomes Stat Down)
Any 'Stat down' pills you take give you a permanent +0.6 Damage Up (Horse pills +1.2)
Most other pills spawn a black heart when used, including R U A Wizard?, Amnesia, Bad Trip, ???, Paralysis, Retro Vision, I'm Excited
+1 Black Heart when picked up
Type: Passive
Item Pool: Devil Room
Spin to Win
ItemID: 655
"Let it rip!"
Quality: 1
While held, gives you an orbital that blocks enemy shots and deals contact damage equal to 3.5 per tick
While the active key is held down, Isaac gains +0.5 Speed and all of your orbitals spin faster and deal more damage
Orbital damage is equal to 1.5 x OrbitalDamage + 6 while this effect is active
Type: Active & Passive, Familiar
Item Pool: Item Room
Vasculitis
ItemID: 657
"Clogged enemies"
Quality: 1
On death enemies now fire tears in random directions, which can damage other enemies
The amount of tears created by this effect depends on the total health of the enemy killed. Smaller enemies spawn 2-3 tears, and bosses spawn a maximum of 16
Tears from this effect maintain tear modifiers and status effects that Isaac currently has
Isaac doesn't take damage from the tears created by this item
Type: Passive
Item Pool: Item Room
Giant Cell
ItemID: 658
"Micro friends"
Quality: 1
Every time you take damage, a tiny Isaac familiar will spawn, which follows you and shoots tears at nearby enemies that deal 1.3 Damage
The mini-Isaacs stay with you between floors, but can die if they take too much damage
Maximum number of mini-Isaacs is 16 at one time
Mini-Isaac's keep some of the abilities and appearance that Isaac has - e.g. the ability to fly. As Azazel they fire brimstone and as The Forgotten they use a bone club
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Tropicamide
ItemID: 659
"Tear size + range up"
Quality: 1
+1.5 Range Up
Tear Size Up
Type: Passive
Item Pool: Boss Room
Card Reading
ItemID: 660
"A link to your future"
Quality: 3
At the beginning of all future floors, two portals will appear, that can take you to either the Boss room (Red portal), Item room (Yellow portal) or Secret room (Blue portal)
After Chapter 3 (The Depths floors) only one portal will spawn
Portals disappear if you leave the starting room
Counts as 1 of 3 astrology items needed in the same run to unlock Planetariums
Type: Passive
Item Pool: Shop
Quints
ItemID: 661
"They lurk inside"
Quality: 2
Every time an enemy dies, a random familiar spawns where it was killed for the rest of the room
The familiar cannot move, but continues to do its usual abilities
Possible familiars include: Abel, Boiled Baby, Brother Bobby, Sister Maggy, Little Steven, Demon Baby, Multidimensional Baby, Freezer Baby, Rotten Baby, Harlequin Baby, Ghost Baby, Guardian Angel, Lil Brimstone, Robo-Baby and Seraphim
Counts as 1 of 3 familiar items needed towards the Conjoined transformation.
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Tooth and Nail
ItemID: 663
"You feel prickly"
Quality: 2
Every 5 seconds you become spiky for a second, becoming immune and dealing 40 contact damage to any enemies that touch you
The effect is indicated by 4 white flashes, where the item activates on the 4th flash
If timed well, can be used to enter curse rooms and open spiky chests without taking damage. You still take damage however when using Blood Donation machines and Devil Beggars
Type: Passive
Item Pool: Item Room
Binge Eater
ItemID: 664
"All you can eat"
Quality: 4
Causes all pedestal items to show up as rotating items, that swap every 1 second between the original spawned item and a HP up item. This allows you to choose between the item that originally spawned and a HP upgrade every time
This effect applies to most items, including those in the shop and devil room. Doesn't apply to progress items like The Polaroid
When you pick up an item that increases your maximum HP, you gain 2 permanent stat increases, and a temporary damage boost that slowly goes down over time. Starts at +3.6 damage and goes to 0 after 30 seconds
While this temporary damage boost is active, each enemy you kill increases your damage slightly, allowing you to quickly kill multiple enemies and chain the effect for longer
This item also gives a -0.03 Speed Down for every food item held
The 2 permanent stat increases depend on the item taken:
A Snack = +0.2 shot speed, +1 luck. Breakfast = +0.2 shot speed, +1.5 Range. Dessert = +1 Flat Damage, +0.2 shot speed. Dinner = +0.5 tears, +0.2 shot speed.
Lunch = +0.5 tears, +1.5 range. Midnight Snack = +1 flat damage, +1 luck. Rotten Meat = +1 flat damage, +1.5 range. Supper = +0.5 tears, +1 luck.
Type: Passive
Item Pool: Secret Room
Guppy's Eye
ItemID: 665
"An eye for secrets"
Quality: 2
Shows you to see the contents of chests, sacks, shopkeepers and items that will drop from fires before you destroy them
Doesn't work on tinted rocks and other obstacles (e.g. poop, pots)
Counts as 1 of 3 cat items needed towards the Guppy transformation
Unlock this item by defeating Mother in the Corpse II as Cain
Type: Passive
Item Pool: Devil Room, Curse Room, Red Chest
Strawman
ItemID: 667
"A helping hand"
Quality: 2
Spawns a Keeper familiar, that shoots triple tears and follows your exact movements as you walk
The keeper has 3 health coins and can die if it takes enough damage. He can pick up coins to restore health
Similar to other familiars of this kind, you can hold the drop key to cause him to stand still
If he dies, his corpse turns into a few blue spiders. He won't respawn even if you move to a new floor
Will always match your current movement speed
+1 Bomb
Unlock this item by defeating The Beast as Tainted Keeper
Type: Passive, Familiar
Item Pool: Secret Room
Dad's Note
ItemID: 668
"..."
Quality: 0
Only found in the Mausoleum/Gehenna II boss room
The item itself has no effect, but triggers the ascent through the backwards path towards the Home floor
Once you've beaten Mother once, a door will appear at the starting room in Depths II, which leads to the Mausoleum/Gehenna floors. The door can only be opened if you have The Polaroid, The Negative or Faded Polaroid (the item/trinket is taken away when it opens). This means you need a way to teleport out of the Mom's Foot boss fight. If you didn't find one before this point, there will be a tinted Skull somewhere on Depths II, which contains a Fool card when blown up.
Cannot be rerolled by 4-pip dice rooms and Spindown Dice
Type: Passive
Item Pool: None (see above)
Sausage
ItemID: 669
"All stats up"
Quality: 3
+1 HP
+0.2 Speed Up
+0.5 Tears Up
+0.5 Damage Up
+1.5 Range Up
+0.16 Shot Speed Up
+1 Luck Up
+6.9% Devil/Angel Room chance
+6.9% Planetarium chance
Type: Passive
Item Pool: Secret Room
Options?
ItemID: 670
"There might be options"
Quality: 2
Clearing a room will spawn an extra reward, however only one can be picked up - the other one will disappear
Unlock this item by defeating the The Beast as Isaac
Type: Passive
Item Pool: Shop
Candy Heart
ItemID: 671
"Power of love"
Quality: 1
Every half red heart you pick up gives a small but permanent stat increase
Randomly picks between +0.10 Damage Up, +0.05 Tears Up, +0.15 Range Up, +0.02 Speed Up, +0.1 Luck Up, +0.02 Shot Speed Up per half red heart
Spawns 1 Red Heart when picked up
Unlock this item by defeating The Beast as Magdalene
Type: Passive
Item Pool: Item Room
A Pound of Flesh
ItemID: 672
"Blood money"
Quality: 1
This item causes Devil deals to cost money instead of hearts, and shop items to cost hearts instead of money
Shop items cost heart containers, and pickups have spikes around them
The Devil deal conversion rate is 1 heart container to 15 coins
Devil deal items can be on discount similar to the shop, making it 1 heart container = 7 coins instead
Unlock this item by defeating The Beast as Cain
Type: Passive
Item Pool: Devil Room, Demon Beggar
Redemption
ItemID: 673
"Deliver me from evil"
Quality: 2
Every time you enter a devil room and choose not to take an item, you get +1 Damage Up upon entering the next floor
The effect is shown via a cross above Isaac's head. Taking a Devil deal breaks the cross and prevents the damage up next floor
Taking free pickups such as Black hearts in the Devil room also count
Unlock this item by defeating The Beast as Judas
Type: Passive
Item Pool: None
Spirit Shackles
ItemID: 674
"Unfinished business"
Quality: 2
When you die, you turn into a ghost with 1/2 a red heart and flying, that is chained to your body for 10 seconds. This allows you to stay alive as long as you don't get hit during this 10 second period
After this effect occurs, it cannot activate again until Isaac gains a half or full Soul Heart or a Black Heart. Soul Hearts that are used to charge Spirit Shackles will not be added to your health as normal
Unlock this item by defeating The Beast as The Forgotten
Type: Passive
Item Pool: Secret Room
Cracked Orb
ItemID: 675
"Shards of knowledge"
Quality: 1
Taking damage reveals a random room on the minimap, and automatically opens certain doors in the current room. Possible doors include any needing a key to open (Item Room, Shop, Alt Path doors), secret rooms and crawl spaces
Cracked Orb can also reveal the location of the red room that contains a pedestal item. The Red Key item is required to access it, but it shows the direction to get there
Unlock this item by defeating The Beast as Eve
Type: Passive
Item Pool: Item Room, Secret Room
Empty Heart
ItemID: 676
"It multiplies"
Quality: 1
Upon entering each new floor, if you have one red heart or less, another one is added
This effect works while moving up floors in the backwards path
This item has no effect for characters with non-red health i.e. ???, Keeper and The Forgotten
Unlock this item by defeating The Beast as Samson
Type: Passive
Item Pool: Item Room, Demon Beggar
Astral Projection
ItemID: 677
"The true out-of-body experience!"
Quality: 2
The first time you take damage in a room, Isaac will become a ghost and time will stop for 3 seconds
During this ghost effect, you gain flight, spectral tears and the damage from the next hit you take is negated
Isaac returns to his body if you either clear the room or take damage while in ghost form
Only happens once per room - taking damage a second time does not turn you into a ghost again
Unlock this item by defeating The Beast as Lazarus
Type: Passive
Item Pool: Item Room, Secret Room
C Section
ItemID: 678
"Fetus shots"
Quality: 4
Your tears are replaced with a charge attack that fires a homing, spectral fetus
The fetus tears deal damage equal to 75% of your current tear damage while in contact with enemies, roughly 5 times per second
Can't be held down like normal charge attacks, they will release automatically at full charge
Unlock this item by defeating The Beast as Lilith
Type: Passive
Item Pool: Item Room, Ultra Secret Room
Lil Abaddon
ItemID: 679
"Abyssal friend"
Quality: 2
Gives you a familiar that can be charged up to release a black ring, that damages any enemies that touch it with rapid hits (similar to Maw of the Void / Athame effects)
The effect does a decent amount of damage, but doesn't scale with your damage upgrades
Counts as 1 of 3 familiar items needed towards the Conjoined transformation.
Unlock this item by defeating The Beast as Azazel
Type: Passive, Familiar
Item Pool: Devil Room
Montezuma's Revenge
ItemID: 680
"Oh no..."
Quality: 2
While firing tears, you now charge up a poop attack for 3 seconds that when released, fires from Isaac's behind
The poop attack deals your current tear damage to any enemies caught in the blast
Counts as 1 of 3 poop items needed towards the Oh Crap transformation
Unlock this item by defeating The Beast as ???
Type: Passive
Item Pool: Item Room
Lil Portal
ItemID: 681
"It hungers"
Quality: 1
Gives Isaac a little portal familiar, that moves across the screen as you're firing
The portal will suck up any consumables and trinkets it travels over, causing it to become larger and deal more contact damage
When the portal sucks up 4 pickups, it turns into a portal that can be used to teleport to unexplored rooms around the floor. It can take you to rooms that require bombs/keys, e.g. the Secret Room or the Shop
Every time the portal sucks up an item, it spawns a blue attack fly for you
Once every room has been explored, the portal does nothing
Cannot take you to rooms that aren't a part of the floor structure e.g. Devil Rooms / I AM ERROR rooms
Unlock this item by defeating Mother as Apollyon
Type: Passive, Familiar
Item Pool: Item Room
Worm Friend
ItemID: 682
"Clingy buddy"
Quality: 3
You gain a familiar that lives under the floor. Every so often it will come up and attempt to grab onto a random enemy in the room, holding them in place and dealing damage
The Worm Friend deals 4 damage for 8 ticks total
If the enemy moves quickly enough it can miss its attack
Unlock this item by defeating The Beast as Apollyon
Type: Passive, Familiar
Item Pool: Item Room
Bone Spurs
ItemID: 683
"Break your enemies"
Quality: 2
Enemies that die will leave behind 1-2 floating bone shards where they die, until you leave the room
Other enemies that touch the bone shards will take 3.5 damage, with a chance to either bounce off them or cause it to break and disappear
Unlock this item by defeating Mother as The Forgotten
Type: Passive
Item Pool: Item Room
Hungry Soul
ItemID: 684
"Out for blood"
Quality: 2
Each time an enemy dies, a friendly red soul appears. It will hunt down other enemies, dealing contact damage which scales with your tear damage
After 5 seconds the red soul explodes (Isaac doesn't take damage from this effect)
Unlock this item by defeating The Beast as The Lost
Type: Passive
Item Pool: Devil Room
Jar of Wisps
ItemID: 685
"Your faith grows"
Quality: 2
When used, gives you number of blue flame orbitals based on the number shown over this item
It starts at 1, and increments each activation, giving you more familiars each time you use it
The flames fire tears at the same time Isaac does, that deal a flat 3 damage
If a flame touches an enemy, it deals contact damage equal to double your current tear damage and then disappears
You can have a maximum of 24 flame orbitals at once
Each flame has a chance to spawn as one of many variants, such as green flames that poison enemies, or a crucifix flame that spawns a random horseman familiar + Locusts when it is extinguished
Unlock this item by defeating The Beast as Bethany
Type: Active
Recharge Time: 12 rooms
Item Pool: Angel Room
Soul Locket
ItemID: 686
"Power of faith"
Quality: 1
Spawns 1 soul heart on the floor
Soul hearts give you small permanent stat increases when picked up
Possible stats include +0.3 Range Up, +0.2 Luck Up, +0.2 Damage Up, +0.1 Tears Up, +0.04 Speed Up
Unlock this item by defeating Greed Mode as Bethany
Type: Passive
Item Pool: Angel Room
Friend Finder
ItemID: 687
"Best friends forever!"
Quality: 3
Spawns a random charmed enemy which fights by your side and copies your exact movements, similar to how Jacob & Esau work
The familiars fire tears at the same time as Isaac, and have a visible health bar showing how much damage they can take before dying
Unlock this item by defeating The Beast as Jacob & Esau
Type: Active
Recharge Time: 4 rooms
Item Pool: Item Room, Crane Game
Inner Child
ItemID: 688
"Let him free"
Quality: 2
Gives you an extra life
You respawn as a tiny version of Isaac, with a greatly reduced hitbox and +0.2 Speed Up
When the effect activates you deal 35 damage to nearby enemies
Once unlocked, if you have already unlocked the tainted version of the character you're playing as, Inner Child is guaranteed to spawn in the hidden closet on the Home floor
Unlock this item by defeating Greed Mode as Jacob & Esau
Type: Passive
Item Pool: Secret Room
Glitched Crown
ItemID: 689
"?????"
Quality: 4
Item pedestals now cycle between 5 random items
Unlock this item by defeating The Beast as Tainted Isaac
Type: Passive
Item Pool: Secret Room
Belly Jelly
ItemID: 690
"Bounce away!"
Quality: 3
Enemies that touch Isaac will now bounce off him and fly off in the opposite direction
Bounced enemies will take 10 damage if they slam into the wall
This item also gives a random chance for enemy shots to bounce off you without taking damage
Unlock this item by defeating The Beast as Tainted Magdalene
Type: Passive
Item Pool: Item Room
Sacred Orb
ItemID: 691
"Destined for greatness"
Quality: 4
Increases the quality of generated items
Rerolls items with a quality of 0 or 1
33% chance to reroll items with a quality of 2
Quality is a hidden mechanic in Repetance for all items and ranges from 0-4. Certain items consider Quality for picking what item to spawn, allowing better items to spawn under certain conditions
Counts as 1 of 3 angel items needed towards the Seraphim transformation.
Unlock this item by defeating The Beast as Tainted Lost
Type: Passive
Item Pool: Angel Room, Secret Room
Sanguine Bond
ItemID: 692
"He awaits your offering"
Quality: 1
Spawns a special set of spikes in the Devil Room
Taking damage from the spikes has a chance to spawn a reward
Nothing - 37.5% chance
6 Pennies - 17% chance
+0.5 Damage Up - 27.5% chance
2 Black Hearts - 9.5% chance
Random Item - 5.5% chance
Leviathan trasformation - 3% chance
Unlock this item by defeating The Beast as Tainted Judas
Type: Passive
Item Pool: Devil Room, Curse Room
The Swarm
ItemID: 693
"Infest"
Quality: 2
When picked up, this gives you 9 orbital flies
Each time a fly blocks an enemy shot, it will turn into a blue fly and attack nearby enemies, leaving you with one less orbital
Every room clear gives you +1 orbital fly, up to a maximum of 9
Counts as 1 of 3 fly items needed towards the Beelzebub transformation.
Unlock this item by defeating The Beast as Tainted Blue Baby
Type: Passive
Item Pool: Item Room, Key Beggar
Heartbreak
ItemID: 694
"Eternal sorrow"
Quality: 3
Gives you +0.25 Damage Up for every broken heart you have
Gives 3 broken hearts when picked up
Every hit of damage that would kill you, instead adds 2 more broken hearts and deal 40 damage to all enemies in the room
Heartbreak cannot kill you on pickup
Broken hearts are empty heart containers that cannot be removed or refilled and will override other types of hearts when you reach 12 total. Replacing all 12 containers with broken hearts will kill you instantly. The only way to remove broken hearts is by donating to a Confessional Machine
Unlock this item by defeating The Beast as Tainted Eve
Type: Passive
Item Pool: Devil Room, Curse Room
Bloody Gust
ItemID: 695
"May your rage bring haste"
Quality: 2
Every time you take damage, you gain a Speed Up and a Tears Up
The stat increases start small, and scale up each time you take damage (+0.25 Tears Up for the first hit, +0.75 Tears Up for the 6th hit)
The effect maxes out at +3 Tears Up and +1 Speed Up after taking damage 6 times. This brings you to the maximum possible speed
The effect lasts for the rest of the current floor
Unlock this item by defeating Mother as Samson
Type: Passive
Item Pool: Item Room, Devil Room
Salvation
ItemID: 696
"Divine protection"
Quality: 3
Isaac gains a halo of light around him. When an enemy touches the halo for couple of seconds, a beam of light will come down and deal a burst of damage to it
The triggered beam also fires in all 4 cardinal directions, dealing damage to anything it touches
Every time Isaac takes damage, the halo grows slightly bigger up to a maximum of 10 times. The size resets when leaving the floor
Counts as 1 of 3 angel items needed towards the Seraphim transformation.
Unlock this item by defeating The Beast as Tainted Lazarus
Type: Passive
Item Pool: Angel Room
Vanishing Twin
ItemID: 697
"He wants revenge"
Quality: 2
A fetus familiar follows Isaac, and upon entering the Boss room on each floor, it will transform into a copy of the boss
This makes bosses a lot harder, however you now get 2 boss item drops
Unlock this item by defeating Hush as Jacob & Esau
Type: Passive, Familiar
Item Pool: Secret Room, Curse Room
Twisted Pair
ItemID: 698
"Double trouble!"
Quality: 4
You gain two familiar demons, that stay by Isaac's side and fire shots in the same direction as you
The familiars deal roughly 40% of Isaac's damage, scaling with damage upgrades you get
They sit near and rotate around Isaac depending on which way you're firing tears. They do not block enemy shots
Counts as 1 of 3 familiar items needed towards the Conjoined transformation.
Unlock this item by defeating The Beast as Tainted Lilith
Type: Passive, Familiar
Item Pool: Devil Room
Azazel's Rage
ItemID: 699
"Ancient power"
Quality: 2
Isaac builds rage each time you clear a new room. This is shown by the Azazel skin spreading on Isaac's face
After 4 rooms, Isaac's face will flash red. The next room you enter he will automatically fire a massive red brimstone laser for 4 seconds, dealing huge damage
The rage resets back to zero, and the cycle continues every 5 rooms cleared
Unlock this item by defeating The Beast as Tainted Azazel
Type: Passive
Item Pool: Devil Room
Echo Chamber
ItemID: 700
"I can see see the future future future"
Quality: 3
When using a card, pill, or rune, you also use a copy of the last 3 cards/pills/runes you used after picking up Echo Chamber
Counts as 1 of 3 astrology items needed in the same run to unlock Planetariums
Unlock this item by defeating The Beast as Tainted Apollyon
Type: Passive
Item Pool: Secret Room
Isaac's Tomb
ItemID: 701
"Buried memories"
Quality: 3
Spawns an Old chest at the start of all future floors
Old Chests work the same as Golden Chests, requiring a key to open but contain different items
The Old chest can contain: 3 trinkets (42% chance), 1-3 soul hearts (43% chance), a random item from the Old Chest pool (10% chance) or an angel room item (5% chance)
Spawns a second chest in the mirrored floor of Downpour II or Dross II, but only if you had this item before entering the floor
Unlock this item by defeating The Beast as Tainted Forgotten
Type: Passive
Item Pool: Secret Room
Vengeful Spirit
ItemID: 702
"Hot blooded"
Quality: 1
Each time you take damage, a red flame orbital will appear around Isaac for the remainder of the floor, up to a maximum of 6
The flames deal contact damage which scales with your tear damage
Upon reaching 6 flames, they will also start to fire tears along with Isaac, dealing a flat 3.2 damage per tear
When entering a new floor, all the flames disappear
Unlock this item by defeating The Beast as Tainted Bethany
Type: Passive
Item Pool: Devil Room, Curse Room
Esau Jr
ItemID: 703
"Lost brother"
Quality: 2
Using this item swaps you between the character you started as, and Esau, which has 3 black hearts, +2 base damage and the ability to fly
This character keeps its own separate health and items. Items picked up are not shared between the two characters
If either character dies it's game over
Unlock this item by defeating The Beast as Tainted Jacob
Type: Active
Recharge Time: 1 room
Item Pool: Item Room, Secret Room
Berserk!
ItemID: 704
"Rip and tear"
Quality: 2
When activated, Isaac's tears are replaced by a bone sword and he goes on a killing rampage, gaining +0.4 Speed, +3 Flat Damage Up for 5 seconds
The sword deals x3 damage if used at close range, or x1.5 damage if charged up and thrown
Clearing rooms doesn't charge this item - charge is added equal to damage taken by enemies. This includes all sources of damage, including environmental damage to enemies
Killing an enemy while berserk will increase the duration of the effect by 1 second
You don't die while in Berserk mode, but taking lethal damage will kill you after the effect wears off
The bone sword from this item is similar to Donkey Jawbone from Antibirth
Tainted Samson starts with a passive version of this item
Unlock this item by defeating Delirium as Tainted Samson
Type: Active
Recharge Time: Enemy damage taken = charge
Item Pool: Devil Room
Dark Arts
ItemID: 705
"One with the shadows"
Quality: 2
When used, Isaac turns into a ghost for 1 second and his speed goes up to maximum (2.0). During this time he can walk over enemies to mark them for death. When the effect wears off, Isaac quickly runs between each marked enemy, dealing high damage to each one rapidly (roughly x2.5 your tear damage)
The damage caused by this effect scales up with every target it hits in a row
Tainted Judas starts with this item
Unlock this item by defeating Delirium as Tainted Judas
Type: Active
Recharge Time: 7 seconds
Item Pool: Devil Room
Abyss
ItemID: 706
"Come forth from the depths"
Quality: 4
When used, Abyss consumes all pedestal items in the current room and converts them into Red attack flies
Red attack flies will charge across the room in the same direction Isaac is shooting, dealing contact damage to enemies equal to Isaac's tear damage
The flies don't block enemy shots, but this also means they never die and stay with Isaac forever
Tainted Apollyon starts with this item
Unlock this item by defeating Delirium as Tainted Apollyon
Type: Active
Recharge Time: 4 rooms
Item Pool: Devil Room
Supper
ItemID: 707
"HP up"
Quality: 1
+1 HP Up
Type: Passive
Item Pool: Boss Room
Stapler
ItemID: 708
"DMG up"
Quality: 3
+1.0 Damage Up
Staples one of Isaac's eyes shut, meaning he only shoots tears from one eye. This means some effects such as R U A WIZARD pills only fire tears in one direction
Type: Passive
Item Pool: Boss Room
Suplex!
ItemID: 709
"Angel breaker"
Quality: 2
When used, you charge forwards for a second. If you touch an enemy in that time, Isaac will pick it up and slam it on the ground, killing it and sending a shockwave around the impact
In the brief period while holding the enemy you can move a target to decide where it lands
Actually does work on bosses! However after the attack you end up near the boss, which puts you in danger of taking damage too
Scales in damage and area of effect with the player's size
Unlock this item by defeating Delirium as Jacob & Esau
Type: Active
Recharge Time: 8 seconds
Item Pool: Item Room, Crane Game
Bag of Crafting
ItemID: 710
"Make your destiny"
Quality: 3
When used will do a swipe attack in any direction. Can be used to store up to 8 consumables in, such as hearts, coins, keys, bombs, cards etc
When the bag has 8 items you can hold down the activate button for 2 seconds to craft yourself a brand new random item
Bag of Crafting's recipes are based on your current seed, but there are some fixed recipes that exist in every run, e.g. 8 coins = Slot Machine
While playing as Tainted Cain you get a visual interface to see what items are in the bag, allowing you to see what item will be created and swap out specific consumables
Has other uses - Will deal 3 damage to enemies it hits, and can be used to quickly push bombs and objects across rooms
Tainted Cain starts with this item, but can be used by any character after unlocking it and finding it in the item room
Cannot be used to craft another Bag of Crafting!
Unlock this item by defeating Delirium as Tainted Cain
Type: Active
Recharge Time: Instant
Item Pool: Item Room
Flip
ItemID: 711
"Life and death"
Quality: 4
While holding flip, a ghost item will appear behind item pedestals upon entering Item Rooms and Shop that cannot be interacted with
When activated, all real items in the room will be swapped with the ghost items behind them
The ghost item stays there even if you take the regular item, allowing you to use Flip to get both of them
Does nothing with item pedestals that don't have a ghost item behind them
When playing as Tainted Lazarus, activating Flip also changes you between Lazarus and Dead Lazarus
Tainted Lazarus starts with this item, but can be used by any character after unlocking it and finding it in the item room
Unlock this item by defeating Delirium as Tainted Lazarus
Type: Active
Recharge Time: 6 rooms
Item Pool: Curse Room, Secret Room, Shop
Lemegeton
ItemID: 712
"Item summoner"
Quality: 3
When used, gives you an orbital flame which represents another random passive item in the game. While you have this flame you also have that item's effect
The flame deals double your tear damage to any enemies that touch it, but if it takes too much damage the flame will disappear and you lose the item's effect
Tainted Bethany starts with this item
Wisps are randomly chosen from Item Room, Boss Room and Shop item pools, with a 25% chance to pick the same pool as the current room
Counts as 1 of 3 book items needed towards the Bookworm transformation.
Unlock this item by defeating Delirium as Tainted Bethany
Type: Active
Recharge Time: 6 rooms
Item Pool: Devil Room, Library
Sumptorium
ItemID: 713
"Return"
Quality: 3
When used, removes half a heart of health and creates a clot familiar
Clot familiars follow Isaac's exact movements including flight, firing tears and tear effects
Holding down the swap button will cause all your clots to stay in place
Works differently as Tainted Eve - instead clots are created by firing for 2 seconds, down to a minimum of half a red heart. Using Sumptorium as her will then cause all Clots to be consumed and return your hearts back to you. Clots returning back to Eve deal 3x damage as they suck back in
The type of heart consumed to create a clot will give it different abilities: Soul Hearts = More health, Black Hearts = Dark Matter effect, Eternal Hearts = Sacred Heart effect, Gold Hearts = Midas Touch effect, Bone Hearts = Compound Fracture effect, Rotten Hearts = Less health
Tainted Eve starts with this item, but can be used by any character after unlocking it and finding it in the item room
This item comes along with Tainted Eve. The achievement 'Sumptorium' is unlocked by defeating Delirium as Tainted Eve
Type: Active
Recharge Time: 10 seconds
Item Pool: Item Room
Recall
ItemID: 714
"Come back"
Quality: 0
When used, this will retreive the Tainted Forgotten's skeleton back to its owner's hands from any distance
Tainted Forgotten's Birthright effect. Cannot be obtained and has no use for any other character
Birthright is a Shop item that has unique effects depending on what character you're playing as
Type: Active
Recharge Time: 3 seconds
Item Pool: None
Hold
ItemID: 715
"Saved for later"
Quality: 0
This is the item Tainted Blue Baby (???) uses as his main mechanic
Killing or damaging enemies spawns various poops, which add to his collection. Pressing the bomb button will put the next poop into the 'Hold' jar. Pressing it again allows you to throw it at enemies. Each poop has random effects like Butt Bombs, Fire Poops etc
Tainted Blue Baby starts with this item, and is the only one who can use it
Type: Active
Recharge Time: Instant
Item Pool: None
Keeper's Sack
ItemID: 716
"Spending power"
Quality: 3
Spawns 3 random coins and a key when picked up
Buying items from the shop gives you random stat upgrades. The more you spend the higher the stat increase
Possible stats include Speed, Damage and Range
15c items give all 3 stats: +1 Damage Up, +0.03 or +0.06 Speed Up, +0.25 or +0.5 Range Up
5c items give 1 or 2 stats: +0.5 Damage Up **OR** +0.25 Range and +0.03 Speed Up
Unlock this item by defeating Mother as The Keeper
Type: Passive
Item Pool: Shop, Secret Room
Keeper's Kin
ItemID: 717
"Under a rock"
Quality: 2
While in a room with enemies, blue spiders will randomly spawn from objects in the room (e.g. rocks, pots, stone blocks)
All rocks spawn 0-2 blue spiders when destroyed
Counts as 1 of 3 spider items needed towards the Spider Baby transformation.
Unlock this item by defeating Delirium as Tainted Keeper
Type: Passive
Item Pool: Item Room, Secret Room
Keeper's Box
ItemID: 719
"Portable shop"
Quality: 2
When used, spawns a random shop item or consumable, however you have to pay the relevant cost to pick it up
Can include anything that would appear in the shop
Unlock this item by defeating The Beast as Keeper
Type: Active
Recharge Time: 4 rooms
Item Pool: Shop, Secret Room, Wooden Chest
Everything Jar
ItemID: 720
"Anything is possible"
Quality: 3
With every bar of charge this item has, a different consumable is shown inside the Jar. 1 = poop, 2 = penny, 3 = bomb, 4 = key, 5 = red heart, 6 = pill, 7 = card, 8 = soul heart, 9 = gold heart, 10 = gold key, 11 = gold bomb
At the full 12 charges, a completely random effect will happen. It can be anything including spawning a bunch of consumables, spawning a glitched pedestal item, creating a bunch of light beams, spawning troll bombs or nothing at all
Unlock this item by defeating The Beast as Eden
Type: Active
Recharge Time: 12 rooms
Item Pool: Item Room, Crane Game
TMTRAINER
ItemID: 721
"Isaac and his mother lived alone in a small house on a hill"
Quality: 0
When picked up, all future items become 'glitched', causing them to become random combinations of 2-3 effects based on other items
Glitched items can be passive or active and are completely randomly generated with infinite possibilities (similar to other 'Randomizer' games)
The ratio of active to passive item effects given is 1/4
Random effects combine effects that exist on other items, and assign them to a random event (e.g. on enemy death, on room clear, on damage taken etc.)
Unlock this item by defeating The Beast as Tainted Eden
Type: Passive
Item Pool: Secret Room
Anima Sola
ItemID: 722
"Repent"
Quality: 2
When used, it puts the closes enemy in chains for 5 seconds, preventing it from moving. You can release the enemy early by using it again
Tainted Jacob starts with this item. While playing as him Anima Sola will always target Dark Esau. Releasing Dark Esau will cause him to charge directly at Jacob and deal damage to anything in his path. If used in a room with no enemies, Dark Esau will instantly spawn
Will chain up to two targets if you have Car Battery, if only one valid target is present it will be chained for twice the duration
Unlock this item by defeating Delirium as Tainted Jacob
Type: Active
Recharge Time: 15 seconds
Item Pool: Item Room
Spindown Dice
ItemID: 723
"-1"
Quality: 4
Rerolls all pedestal items, lowering all their internal item IDs by 1
For example: Brimstone's ID = 118, so it would be rerolled into Dead Bird (ID = 117)
Sad Onion (ID = 1) will reroll into nothing
There are some gaps in item IDs which are skipped if no item exists, or will reroll into unexpected items if hidden items are present at that ID. For example rerolling Plan C (ID = 475) changes it into the Broken Glass Cannon, which is a hidden item with ID = 474
Items that are yet to be unlocked will also be skipped over, preventing you from getting items you don't have access to yet
Unlock this item by defeating Delirium as Tainted Isaac
Type: Active
Recharge Time: 6 rooms
Item Pool: Item Room, Secret Room, Crane Game
Hypercoagulation
ItemID: 724
"Thick blooded"
Quality: 2
Upon taking damage you have a chance to drop the heart that you just lost. It gives you 2 seconds to pick it up again to re-heal, before it disappears
Unlock this item by defeating Delirium as Tainted Magdalene
Type: Passive
Item Pool: Item Room
IBS
ItemID: 725
"Your stomach rumbles"
Quality: 0
Whenever you deal damage to an enemy, has a chance to give the effect of one of Tainted ???'s unique poops
Corn poop - Spawns a blue fly every 2 seconds
Flaming poop - Leaves behind fire that damages enemies
Stinky poop - Emits a toxic cloud
Black poop - Creates slowing black creep. Confuses all enemies briefly when destroyed
White poop - Same effect as Hallowed Ground
Stone poop - Deals extra thrown damage, can hit multiple enemies. Takes more shots before breaking
Bomb poop - Throws a butt bomb that explodes after 2 seconds
Unlock this item by defeating Delirium as Tainted Blue Baby
Type: Passive
Item Pool: Item Room
Hemoptysis
ItemID: 726
"Double tap sneeze"
Quality: 2
Allows you to quickly double tap a shoot button to sneeze on nearby enemies, dealing x1.5 your tear damage and pushing them back slightly
If an enemy is pushed into a wall or object it takes 10 damage
Unlock this item by defeating Delirium as Tainted Azazel
Type: Passive
Item Pool: Item Room
Ghost Bombs
ItemID: 727
"Spooky blast +5 bombs"
Quality: 2
+5 Bombs
Bombs become spectral and can now pass through objects
Bombs spawn a friendly white soul, which will hunt down other enemies, dealing contact damage which scales with your tear damage
After 10 seconds the white soul explodes dealing 7 damage to nearby enemies. Isaac doesn't take damage from this effect
Unlock this item by defeating Delirium as Tainted Lost
Type: Passive
Item Pool: Item Room, Bomb Beggar
Gello
ItemID: 728
"Demonic gestation"
Quality: 3
Spawns a familiar that's attached via an Umbilical Cord, but will move and shoot in the same direction Isaac is shooting
When activated you first need to throw the familiar, which deals x3 your tear damage to any enemies it touches
Gello's tears deal x0.75 your tear damage (x1.0 if Lilith)
Can be used multiple times per room to spawn more familiars, however they only last for the current room
Unlock this item by defeating Delirium as Tainted Lilith
Type: Active
Recharge Time: 2 rooms
Item Pool: Item Room, Devil Room
Decap Attack
ItemID: 729
"Chuck away!"
Quality: 2
When used, this item allows you to throw your head where it will sit as a stationary sentry firing bullets until you walk over and pick it up again
Throwing Isaac's head deals 24 damage to anything it hits while being thrown
Your hitbox remains with the body. Enemies touching the head don't hurt Isaac
Unlock this item by defeating Delirium as Tainted Forgotten
Type: Active
Recharge Time: 4 seconds
Item Pool: Item Room
Glass Eye
ItemID: 730
"DMG + luck up"
Quality: 3
+0.75 Damage Up
+1 Luck Up
Type: Passive
Item Pool: Boss Room, Crane Game, Golden Chest
Stye
ItemID: 731
"DMG + range up"
Quality: 2
+28% Damage Up (right eye only)
+7 Range Up (right eye only)
-0.3 Shot Speed Down (right eye only)
Type: Passive
Item Pool: Boss Room
Mom's Ring
ItemID: 732
"DMG up"
Quality: 3
+1 Damage Up
Drops 1 random rune or soul stone when picked up
Counts as 1 of 3 mom items needed towards the Mom transformation
Type: Passive
Item Pool: Shop, Golden Chest, Mom's Chest, Old Chest
Repentance Trinkets (61)
Jawbreaker
TrinketID: 129
"Don't chew on it"
Tears have a chance to become a tooth, dealing x3.2 damage, similar to Tough Love
The chance to fire a tooth with this trinket is affected by your Luck stat
At +0 luck you have ~12% chance for this effect to activate
At +9 luck every tear you fire will be a tooth
Chewed Pen
TrinketID: 130
"It's leaking"
Tears have a chance to slow enemies
Blessed Penny
TrinketID: 131
"Wealth of purity"
Chance to spawn half a soul heart when picking up a coin
The chance scales up based on the coin's worth: Penny = 16.66%, Double Penny = 30.5%, Nickel = 59.7%, Dime = 83.3%
Unlock this trinket by defeating ??? as Bethany
Broken Syringe
TrinketID: 132
"Mystery medicine"
Gives you a random syringe effect every room
The effect can be The Virus, Roid Rage, Speed Ball, Experimental Treatment, Synthoil, Euthanasia or Growth Hormones
Short Fuse
TrinketID: 133
"Faster explosions"
Placed bombs explode after 0.66 seconds instead of the usual 1.5 seconds
This was called Exploded Firecracker in Antibirth
Gigante Bean
TrinketID: 134
"Mega farts"
Farts produced by Isaac or familiars will be twice as large
A Lighter
TrinketID: 135
"Watch the world burn"
Chance for enemies to burn when entering a room
The chance for this effect to activate is effected by your Luck stat
Broken Padlock
TrinketID: 136
"Bombs are key"
Explosions can open locked doors
This includes key blocks and golden chests
Myosotis
TrinketID: 137
"Forget me not..."
Pickups left on current floor will appear in the starting room of the next floor, up to a maximum of 4 pickups
'M
TrinketID: 138
"t's broken9Reroll your dest "
Active items will be rerolled upon using them
Using with Book of Virtues will only reroll the item the book is holding
Has no effect with Notched Axe due to how its durability works
Unlock this trinket by defeating Mother as Eden
Teardrop Charm
TrinketID: 139
"It feels lucky"
Random luck-based tear effects have an extra chance of occurring
The additional chance is effectively +3 Luck Up
Apple of Sodom
TrinketID: 140
"It feels empty"
Picking up red hearts now has a high chance to spawn 1-4 blue attack spiders, instead of giving you health back
This effect also works while fully healed, giving a guaranteed chance of getting spiders
While missing any red health the chance for spiders is less
Works for characters that don't use red health, which always gives you spiders
Hearts in Shops can be converted into spiders for free
Forgotten Lullaby
TrinketID: 141
"Sing for your friends"
Gives your familiars improved rate of fire while held
In Antibirth this trinket was called Song of the Siren
Unlock this trinket by bombing the skull left by The Siren boss after her death
Beth's Faith
TrinketID: 142
"My faith protects me"
While held at the start of each floor, this trinket spawns four wisp familiar orbitals around Isaac
These wisps are the same as the ones created by the Book of Virtues item
Unlock this trinket by beating the Boss Rush as Bethany
Old Capacitor
TrinketID: 143
"Voltage starving"
Your active item no longer gains charges, but battery drops become much more common
Unlock this trinket by blowing up 10 Battery Beggars
Brain Worm
TrinketID: 144
"Ding!"
Tears that miss enemies will redirect themselves and travel 90 degrees towards enemies
Tears must be roughly 2 tiles or closer to activate this effect
Perfection
TrinketID: 145
"Luck way up. Don't lose it!"
+10 Luck while held, but the trinket is destroyed when damage is taken
Blood donation machines, Curse Rooms and Sacrifice Rooms wont destroy it
Taking a hit and activating Holy Mantle won't destroy it
Can be dropped in order to avoid breaking it
This trinket is automatically given to you after clearing 3 bosses without taking damage
Devil's Crown
TrinketID: 146
"His special customer"
Treasure Rooms are replaced with Red Treasure Rooms, which contain a deal with the devil in place of a regular item pedestal
If an item room has not yet been entered, it can be transformed to either a regular or Red Treasure Room by picking up or dropping this trinket before entering
Does not affect the mirrored treasure room in Downpour II
Unlock this trinket by defeating Mother as Azazel
Charged Penny
TrinketID: 147
"Wealth of power"
Every time you pick up a coin, you have a small chance to gain 1 bar of charge on your active item
The chance for this effect to happen is 1/6th of the value of the coin picked up
Can only activate once per coin collected
In Antibirth this trinket was called Electric Penny
Unlock this trinket by donating to a battery beggar until he pays out with an item 5 times
Friendship Necklace
TrinketID: 148
"Gather round"
While held, your familiars will now orbit around Isaac instead of following behind him
Panic Button
TrinketID: 149
"Push in case of emergency"
Activates your active item just before damage would be taken
It doesn't activate for free - the charges are used up as normal if this effect activates. This means the trinket does nothing if your active item isn't fully charged
Single-use active items are consumed as normal
Blue Key
TrinketID: 150
"Look between the rooms"
Doors can be opened without using up a key
However, when entering the door you are taken to a blue womb room with enemies to defeat. This room will always drop a reward at the end, then allow you to exit back to the real floor
Unlock this trinket by defeating The Beast as Tainted Cain
Flat File
TrinketID: 151
"No more spikes"
While held this trinket causes spikes to retract into the floor
Works for curse rooms - you no longer take damage entering or leaving
Allows you to open spiked chests without taking damage
Telescope Lens
TrinketID: 152
"Seek the stars"
+9% chance for a Planetarium to spawn
Allows Planetariums to spawn in the Womb/Utero floors
Planetarium have a base 1% chance to appear, which increases by +20% whenever you skip an Item Room (Must not enter to count as skipped)
After entering a Planetarium the chance goes back to 1%. Holding this trinket increase that chance by +15%
Does not drop in Greed Mode
Unlock this trinket by collecting three of the following in the same run: Magic 8 Ball, Tiny Planet, Crystal Ball, Star of Bethlehem or any of the Astrology-related items (e.g. Aries, Cancer, Capricorn, Leo etc.). The item called Zodiac does not count.
Mom's Lock
TrinketID: 153
"A piece of her love"
Has a high chance to give you the effect of a random Mom item every room
Unlock this trinket by defeating Isaac, ???, Satan and The Lamb as Tainted Isaac
Dice Bag
TrinketID: 154
"Bonus roll"
Every time you enter a brand new room, you have a chance to get a random one-time use Dice (e.g. D6, D20 etc.)
Unlock this trinket by defeating Mother as Tainted Isaac
Holy Crown
TrinketID: 155
"Walk the path of the saint"
Causes Item rooms and Shops to appear in the Cathedral
Unlock this trinket by defeating Isaac, ???, Satan and The Lamb as Tainted Magdalene
Mother's Kiss
TrinketID: 156
"HP up"
While held you get +1 HP Up
The first time you pick this trinket up, the heart container will be filled. This effect can't be abused - next time it will be empty if dropped
Unlock this trinket by defeating Mother as Tainted Magdalene
Torn Card
TrinketID: 157
"Death awaits"
Every 15 shots you will shoot an Ipecac + My Reflection shot
The tear will fly in the air for about 3 seconds and follows Isaac until it falls and explodes. You need to move out of the way or it will hurt Isaac, but can be used to open anything requiring a bomb e.g. Secret Rooms
Unlock this trinket by defeating Mother as Tainted Lazarus
Torn Pocket
TrinketID: 158
"A hole in your pocket"
Every time you take damage, you drop up to 2 different types of consumables on the ground
Dropped consumables can be any variant of its kind - e.g. a bomb can become a troll bomb, or a dropped coin can become a dime
Does nothing if you have no consumables
Unlock this trinket by defeating Isaac, ???, Satan and The Lamb as Tainted Lazarus
Gilded Key
TrinketID: 159
"Less is more"
All new chests become locked Golden chests
Unlock this trinket by defeating Isaac, ???, Satan and The Lamb as Tainted Cain
Lucky Sack
TrinketID: 160
"Free goodies!"
Spawns a sack at the start of each new floor
Unlock this trinket by defeating Mother as Tainted Cain
Wicked Crown
TrinketID: 161
"Walk the path of the wicked"
Causes an Item Room and Shop to appear in Sheol
Unlock this trinket by defeating Isaac, ???, Satan and The Lamb as Tainted Azazel
Azazel's Stump
TrinketID: 162
"Unleash your inner demon"
When entering a new room, gives a small chance to gain Azazel's short-range Brimstone laser for the current room and the ability to fly
Unlock this trinket by defeating Mother as Tainted Azazel
Dingle Berry
TrinketID: 163
"Oops!"
Spawns 2 friendly Dips upon clearing a room
Dips that spawn after killing a Squirt turn friendly
Unlock this trinket by defeating Isaac, ???, Satan and The Lamb as Tainted Blue Baby
Ring Cap
TrinketID: 164
"Twice the bang!"
Drops 2 bombs at once (only 1 bomb is removed from your total)
Unlock this trinket by defeating Mother as Tainted Blue Baby
Nuh Uh!
TrinketID: 165
"Don't want!"
Beyond the womb floor, replaces all coin and key spawns with a random pickup as follows:
Bomb - 26.6% chance. Heart - 26.6% chance
Pill - 16.6% chance. Card - 16.6% chance
Trinket - 6.6% chance. Battery - 6.6% chance
Also adds a 20% chance to spawn a fly if the original drop was a coin
Doesn't spawn in Greed Mode
Unlock this trinket by defeating Isaac, ???, Satan and The Lamb as Tainted Eden
Modeling Clay
TrinketID: 166
"???"
Each brand new room, this trinket has a chance to transform into a copy of a random passive item, which gives you the effect for the duration of this room
Unlock this trinket by defeating Mother as Tainted Eden
Polished Bone
TrinketID: 167
"Friends from beyond"
Gives a small chance to spawn a friendly Bony when clearing a room, which will throw bones at enemies until it takes enough damage to die
Can be either the regular white Bony or the black variant
Unlock this trinket by defeating Isaac, ???, Satan and The Lamb as Tainted Forgotten
Hollow Heart
TrinketID: 168
"A brittle blessing"
Gives you +1 Bone Heart every time you enter a new floor
Unlock this trinket by defeating Mother as Tainted Forgotten
Kid's Drawing
TrinketID: 169
"Looks familiar..."
Counts as 1 of 3 cat items needed towards the Guppy transformation
Dropping this trinket again removes the transformation if you dont have 3 other Guppy items
Unlock this trinket by defeating Isaac, ???, Satan and The Lamb as Tainted Lost
Crystal Key
TrinketID: 170
"Call to the other side"
Each time you clear a room there is a chance a Red Room will spawn at one of the walls.
The chance for a Red Room to unlock increases as you pick up more Crystal Keys.
While in a regular room, the chances to spawn a Red Room are: 1 Key = 33.33% chance. 2 keys = 50% chance. 3 or more keys = 100% chance.
While in a Red room, the chances to spawn a Red Room are: 1 Key = 12.5% chance. 2 keys = 16.6% chance. 3 keys = 25% chance. 4 keys = 50% chance. 5 keys = 100% chance.
Passive rooms with no enemies don't have a chance to spawn Red Rooms.
It's possible to hold more than one trinket by taking Mom's Purse, Belly Button or using the Smelter to convert them into passive items. Having a golden version of this trinket counts as 2 keys.
Doesn't spawn in Greed Mode
Unlock this trinket by defeating Mother as Tainted Lost
Keeper's Bargain
TrinketID: 171
"Money talks"
Has a decent chance for Devil Deals to cost money instead of Health
The conversion rate is 1 heart container to 15 coins
Items can be on discount similar to the shop, making it 1 heart container = 7 coins instead
No effect on Lost or Tainted Lost
Can be dropped to disable this effect while in the room
Unlock this trinket by defeating Isaac, ???, Satan and The Lamb as Tainted Keeper
Cursed Penny
TrinketID: 172
"Wealth of misery"
While held, you will be teleported to a random room everytime you pick up a coin
Unlock this trinket by defeating Mother as Tainted Keeper
Your Soul
TrinketID: 173
"Give it to me"
Allows you to pay for a devil deal with this trinket
Unlock this trinket by defeating Isaac, ???, Satan and The Lamb as Tainted Judas
Number Magnet
TrinketID: 174
"6"
+10% devil room chance while held
Changes Devil Room layouts. The new rooms contain 0-3 Devil Deal Items, 1-3 Black Hearts and random enemies from the Sheol floor
Prevents Krampus from appearing
Unlock this trinket by defeating Mother as Tainted Judas
Strange Key
TrinketID: 175
"What could it open?"
Opens the door to the Blue Womb, regardless of whether you meet the 30 minute speed timer
Opening Pandora's Box while holding this item will ignore the normal effect and instead spawn 6 item pedestals from random item pools. Both the box and trinket are consumed when this happens
Unlock this trinket by defeating Isaac, ???, Satan and The Lamb as Tainted Eve
Lil Clot
TrinketID: 176
"Mini friend"
A small clot friend will hug Isaac, following his exact movements (similar to how Jacob & Esau work) and shooting tears when he does
The clot can be moved around by collision with an object/wall, allowing you to re-position it
The clot's damage is roughly 1/3 of your tear damage
If it takes a few hits it will die, and respawn in the next room
Unlock this trinket by defeating Mother as Tainted Eve
Temporary Tattoo
TrinketID: 177
"You feel braver"
Spawns a random chest after completing a regular Challenge Room
Spawns a pedestal item after completing a boss Challenge Room
Doesn't spawn in Greed Mode
Unlock this trinket by defeating Isaac, ???, Satan and The Lamb as Tainted Samson
Swallowed M80
TrinketID: 178
"Bang!"
When taking damage you have a chance to explode and deal 185 damage to all enemies around you (Same damage as a Mr. Mega bomb)
Unlock this trinket by defeating Mother as Tainted Samson
RC Remote
TrinketID: 179
"Controllable buddies!"
Familiars follow Isaac's exact movements, (similar to how Jacob & Esau work) instead of following loosely like they usually do
Holding the drop button (Ctrl on Steam version) causes them to stop moving
Doesn't affect some familiars with specific movement patterns, e.g. Abel
Unlock this trinket by defeating Isaac, ???, Satan and The Lamb as Tainted Jacob
Found Soul
TrinketID: 180
"Finally!"
Gives you a familiar that follows Isaac's exact movements (similar to how Jacob & Esau work) and shoots spectral tears
Similar to Jacob and Esau, positions can be altered by running it into objects, or holding the drop button (Ctrl on Steam version)
When you place a bomb, the Found Soul will drop one too
If it takes any damage, it will die and not respawn until the next floor
Will always match your current movement speed
Unlock this trinket by defeating Mother as Tainted Jacob
Expansion Pack
TrinketID: 181
"Fun extras"
Everytime you use your active item, you have a chance to activate another random active item
Glowing Hourglass effect is blocked from this item
Unlock this trinket by defeating Isaac, ???, Satan and The Lamb as Tainted Bethany
Beth's Essence
TrinketID: 182
"Virtue's reward"
Taking damage gives you a chance to spawn a flame orbital, similar to the ones created by Book of Virtues
Entering an Angel Room gives you +5 flame orbitals. The angel room spawned by The Stairway item also counts
Giving money to a beggar gives a flame orbital
Unlock this trinket by defeating Mother as Tainted Bethany
The Twins
TrinketID: 183
"I'm seeing double..."
Upon entering each new room, this trinket has a chance to copy one of your current familiars
If you have no familiars instead it will spawn either Brother Bobby or Sister Maggy
Only lasts for the current room
Unlock this trinket by defeating Isaac, ???, Satan and The Lamb as Tainted Lilith
Adoption Papers
TrinketID: 184
"Give them a home"
All shops only sell familiars while holding this trinket
If you enter a shop while holding this trinket, the effect won't undo by dropping it until you move to a new floor
Unlock this trinket by defeating Mother as Tainted Lilith
Cricket Leg
TrinketID: 185
"Infested"
Every time an enemy dies you have a chance to gain a random Locust
Different color Locusts correspond to the horsemen. Each of them deal double your tear damage, similar to how standard blue flies work
War (Red) - Explodes when touching the enemy. The actual explosion deals flat 60 damage
Pestilence (Green) - Poisons the enemy it attacks
Famine (Brown) - Applies a slowing effect
Death (Black) - Deals x4 damage instead of x2
Conquest (White) - Spawns 2-5 at once
Unlock this trinket by defeating Isaac, ???, Satan and The Lamb as Tainted Apollyon
Apollyon's Best Friend
TrinketID: 186
"Attack buddy"
Gives you a red attack fly, that will charge at enemies in the same direction you are shooting
Deals damage equal to your current tear damage
Stops charging once it hits an enemy and returns to Isaac's side
Unlock this trinket by defeating Mother as Tainted Apollyon
Broken Glasses
TrinketID: 187
"Double vision?"
Gives a 33% chance to spawn an extra blind pedestal item in all future item rooms. This one will be a hidden question mark
Allows you to see what both items are on alternative path floors (Downpour/Dross, Mines/Ashpit, Gehenna/Mausoleum)
Unlock this trinket by defeating challenge #40 (Seeing Double)
Ice Cube
TrinketID: 188
"Stay frosty"
Gives a small chance when entering a room for enemies to be petrified for 4 seconds. Killing a petrified enemy will freeze it.
The chance for this effect to activate depends on your Luck stat.
Frozen enemies can be pushed into obstacles where they shatter on contact and fire ice shards around them. Any other enemies hit by these shards will become frozen too
Frozen enemies are considered dead by the game, and won't unfreeze or move again. The room doors will open if only frozen enemies remain
Unlock this trinket by defeating challenge #41 (Pica Run)
Sigil of Baphomet
TrinketID: 189
"Revel in death"
Every time you kill an enemy you get an invincibility shield for 1 second
While shielded, each enemy killed adds +1 seconds to the duration
Unlock this trinket by defeating challenge #37 (Bloody Mary)
Rebirth Items (341)
The Sad Onion
ItemID: 1
"Tears up"
Quality: 3
+0.7 Tears Up
Type: Passive
Item Pool: Item Room
The Inner Eye
ItemID: 2
"Triple shot"
Quality: 2
Tears now shoot three at a time (Triple Shot)
Tears Down significantly - Tears fired per second * 0.51
Type: Passive, Tear Modifier
Item Pool: Item Room
Spoon Bender
ItemID: 3
"Homing shots"
Quality: 3
Gives Isaac's tears a homing effect
Type: Passive
Item Pool: Item Room
Cricket's Head
ItemID: 4
"DMG up"
Quality: 4
+0.5 Damage Up
x1.5 times Damage Multiplier (Does not stack with the Magic Mushroom multiplier)
Can be found in golden chests
Cricket's Head used to be known as Max's Head in the original game and was renamed for Rebirth
Type: Passive
Item Pool: Item Room
My Reflection
ItemID: 5
"Boomerang tears"
Quality: 2
Gives tears a boomerang effect
+1.5 Damage Up
+0.6 Shot Speed Up
-1 Luck Down
Range Up (1.6x + 1.5)
Type: Passive, Tear Modifier
Item Pool: Item Room
Number One
ItemID: 6
"Tears up"
Quality: 2
Gives you a very high tear rate in exchange for a big range down
+1.5 Tears Up
-2.5 Range Down
Type: Passive
Item Pool: Item Room
Blood of the Martyr
ItemID: 7
"DMG up"
Quality: 3
+1.0 Damage Up
x1.5 times Damage Multiplier if you also have Book of Belial (Does not stack with Magic Mushroom or Cricket's Head multipliers)
Type: Passive
Item Pool: Item Room, Angel Room
Brother Bobby
ItemID: 8
"Friends 'till the end"
Quality: 1
A familiar which follows Isaac and shoots normal tears which do 3.5 damage
Counts as 1 of 3 familiar items needed towards the Conjoined transformation
Type: Passive, Familiar
Item Pool: Item Room, Devil Room
Skatole
ItemID: 9
"Fly love"
Quality: 0
A lot of fly enemies are no longer aggressive towards Isaac
Attack Fly, Dart Fly, Eternal Fly, and Ring Fly are transformed into a neutral black fly
Boom Fly, Red Boom Fly, Drowned Boom Fly move slower, but still deal contact damage
Moter, Level 2 Fly, Full Fly, Pooter, and Super Pooter move slower and deal no contact damage
Can only be obtained from the shell game in the arcade
Counts as 1 of 3 fly items needed towards the Beelzebub transformation
Counts as 1 of 3 poop items needed towards the Oh Crap transformation.
Type: Passive
Item Pool: None (Arcade shell game only)
Halo of Flies
ItemID: 10
"Projectile protection"
Quality: 2
Gives Isaac 2 orbital flies which block enemy shots
Picking up this item as well as 2 other fly-type items will allow you to transform into Lord of the Flies
Counts as 1 of 3 fly items needed towards the Beelzebub transformation
Type: Passive, Orbital
Item Pool: Item Room, Key Beggar
1UP
ItemID: 11
"Extra life"
Quality: 2
Gives the player an extra life
When revived, the green mushroom that follows Isaac will disappear and he will respawn with the same amount of red heart containers at full health
Resurrection takes place before all other items which give you an extra life
Type: Passive
Item Pool: Secret Room
Magic Mushroom
ItemID: 12
"All stats up!"
Quality: 4
+1 HP Up
+0.3 Damage Up
x1.5 times Damage Multiplier (Does not stack with the multipliers from Cricket's Head / Blood of The Martyr + Book of Belial)
+1.5 Range Up
+0.3 Speed Up
Increases the size of your player sprite, but doesn't increase the hitbox
Fully restores all red heart containers
Counts as 1 of 3 mushroom items needed towards the Fun Guy transformation
Counts as 1 of 3 size-increasing items needed towards the Stompy transformation
Type: Passive
Item Pool: Item Room, Mushrooms
The Virus
ItemID: 13
"Poison touch"
Quality: 2
Enemies touching you take 12 damage, then a poison effect is applied for 6-7 ticks, dealing damage equal to the amount of red hearts you have (up to 30.8 at 12 full red hearts)
+0.2 Speed Up
Has a chance to drop from the Lust miniboss fight
Counts as 1 of 3 syringe items needed towards the Spun transformation
Type: Passive
Item Pool: Item Room, Demon Beggar, Lust Miniboss
Roid Rage
ItemID: 14
"Speed and range up"
Quality: 2
+0.3 Speed Up
+1.5 Range Up
+0.5 Shot Height
Counts as 1 of 3 syringe items needed towards the Spun transformation
Type: Passive
Item Pool: Item Room, Boss Room, Demon Beggar
<3
ItemID: 15
"HP up"
Quality: 2
+1 HP Up
Fully restores all red heart containers
Has a chance to drop from the Gluttony miniboss fight
Type: Passive
Item Pool: Item Room, Gluttony Miniboss
Raw Liver
ItemID: 16
"HP up"
Quality: 2
+2 Health Up
Full red heart heal
Type: Passive
Item Pool: Secret Room
Skeleton Key
ItemID: 17
"99 keys"
Quality: 3
Gives Isaac 99 Keys
Type: Passive
Item Pool: Item Room, Secret Room
A Dollar
ItemID: 18
"$$$"
Quality: 3
Gives Isaac 100 coins
Can drop from an exploding slot machine while playing it
Type: Passive
Item Pool: None (Arcade machine only)
Boom!
ItemID: 19
"10 bombs"
Quality: 0
+10 Bombs
Type: Passive
Item Pool: Item Room
Transcendence
ItemID: 20
"We all float down here..."
Quality: 3
Gives Isaac the ability to fly
Unlock this item by beating Mom's Heart 3 times
Type: Passive
Item Pool: Secret Room
The Compass
ItemID: 21
"The end is near"
Quality: 2
Shows most icons on the map (Shops, Item Rooms, Boss Rooms etc.)
Does not show the layout of the map
Doesn't show the location of Secret or Super Secret rooms
Room icons will not show if a Curse of the Lost is in effect on the current floor
Type: Passive
Item Pool: Shop, Beggar
Lunch
ItemID: 22
"HP up"
Quality: 1
+1 HP Up
Heals one red heart container when picked up
Type: Passive
Item Pool: Boss Room, Challenge Room, Beggar
Dinner
ItemID: 23
"HP up"
Quality: 1
+1 HP Up
Heals one red heart container when picked up
Type: Passive
Item Pool: Boss Room, Beggar, Challenge Room
Dessert
ItemID: 24
"HP up"
Quality: 1
+1 HP Up
Heals one red heart container when picked up
Type: Passive
Item Pool: Boss Room, Beggar, Challenge Room
Breakfast
ItemID: 25
"HP up"
Quality: 1
+1 HP Up
Heals one red heart container when picked up
Type: Passive
Item Pool: Boss Room, Challenge Room, Beggar
Rotten Meat
ItemID: 26
"HP up"
Quality: 1
+1 HP Up
Heals one red heart container when picked up
Type: Passive
Item Pool: Boss Room, Beggar, Challenge Room
Wooden Spoon
ItemID: 27
"Speed up"
Quality: 1
+0.3 Speed Up
Type: Passive
Item Pool: Boss Room
The Belt
ItemID: 28
"Speed up"
Quality: 1
+0.3 Speed Up
Type: Passive
Item Pool: Boss Room, Gold/Stone Chest
Mom's Underwear
ItemID: 29
"Range Up"
Quality: 1
+1.5 Range Up
Gives 3-6 blue attack flies when picked up
Counts as 1 of 3 mom items needed towards the Mom transformation
Type: Passive
Item Pool: Boss Room, Challenge Room, Gold/Stone Chest, Mom's Chest
Mom's Heels
ItemID: 30
"Range up"
Quality: 1
+1.5 Range Up
Makes Isaac deal 12 contact damage per tick (24 damage per second)
Counts as 1 of 3 mom items needed towards the Mom transformation
Type: Passive
Item Pool: Boss Room, Challenge Room, Mom's Chest
Mom's Lipstick
ItemID: 31
"Range up"
Quality: 1
+2.25 Range Up
Drops a random heart on the floor when picked up
Counts as 1 of 3 mom items needed towards the Mom transformation
Type: Passive
Item Pool: Boss Room, Challenge Room, Mom's Chest
Wire Coat Hanger
ItemID: 32
"Tears up"
Quality: 3
+0.7 Tears Up
Unlock this item by beating Mom's Heart 4 times
Type: Passive
Item Pool: Boss Room, Gold/Stone Chest
The Bible
ItemID: 33
"Temporary flight"
Quality: 1
Gives Isaac angel wings for the current room, allowing him to fly
Instantly kills the Mom's Foot, Mom's Heart and It Lives boss fights
If used during the Satan fight, The Bible will instantly kill Isaac
Counts as 1 of 3 angel items needed towards the Seraphim transformation
Counts as 1 of 3 book items needed towards the Bookworm transformation
Type: Active
Recharge Time: 4 rooms
Item Pool: Shop, Library, Angel Room
The Book of Belial
ItemID: 34
"Temporary DMG up"
Quality: 2
Upon use, gives +2 damage up which lasts for the current room
x1.5 times Damage Multiplier if you also have Blood of the Martyr (Does not stack with Magic Mushroom or Cricket's Head multipliers)
Increases your chances of getting a devil/angel room by +12.5%
Judas starts with this item
Additional uses in the same room or combined with The Devil XV give +1 damage per use
Counts as 1 of 3 book items needed towards the Bookworm transformation
Type: Active
Recharge Time: 3 rooms
Item Pool: Library, Devil Room
The Necronomicon
ItemID: 35
"Mass room damage"
Quality: 1
Deals 40 damage to everything in the room when used
Counts as 1 of 3 book items needed towards the Bookworm transformation
Unlock this item by using 4 XIII - Death cards
Type: Active
Recharge Time: 3 rooms
Item Pool: Library, Secret Room, Devil Room
The Poop
ItemID: 36
"Plop!"
Quality: 0
Drops a poop on the floor
Blue Baby starts with this item
Can be placed next to a pit and exploded to make a bridge
Can be placed over a broken red poop to overwrite it, causing it to no longer regenerate
Counts as 1 of 3 poop items needed towards the Oh Crap transformation
Type: Active
Recharge Time: 1 room
Item Pool: Item Room
Mr. Boom
ItemID: 37
"Reusable bomb buddy"
Quality: 1
Drops a large bomb below the player which does 185 damage
Compatible with bomb modifiers, such as Glitter Bombs, Sticky Bombs etc
Has a chance to drop from the Wrath miniboss fight
Type: Active
Recharge Time: 2 rooms
Item Pool: Item Room, Wrath Miniboss, Bomb Beggar
Tammy's Head
ItemID: 38
"Reusable tear burst"
Quality: 2
Fires 10 tears in a circle around Isaac
Each tear is equal to your damage stat + 25 flat damage
The tears spawned from Tammy's Head retain tear effects of Isaac's tears, such as poison or homing
Type: Active
Recharge Time: 1 room
Item Pool: Item Room, Gold Chest
Mom's Bra
ItemID: 39
"Mass fear"
Quality: 1
When used, freezes all enemies in the current room for about 4 seconds
Counts as 1 of 3 mom items needed towards the Mom transformation
Type: Active
Recharge Time: 3 rooms
Item Pool: Item Room, Challenge Room, Mom's Chest
Kamikaze
ItemID: 40
"Become the bomb!"
Quality: 0
Causes an explosion near Isaac which takes away half a heart and does 40 damage all enemies in close proximity
Does not reduce your devil/angel room chances when used
Type: Active
Recharge Time: Instant
Item Pool: Item Room
Mom's Pad
ItemID: 41
"Gross..."
Quality: 0
When used, causes all enemies in the current room to run away from Isaac in fear for 5 seconds
Spawns 1 blue attack fly per use
Counts as 1 of 3 mom items needed towards the Mom transformation
Type: Active
Recharge Time: 2 rooms
Item Pool: Item Room, Challenge Room, Mom's Chest
Bob's Rotten Head
ItemID: 42
"Reusable ranged bomb"
Quality: 1
A poison bomb which can be thrown and leaves a poison effect on any enemies within the blast radius. It also leaves a gas cloud at the place where it exploded
The bomb deals 185 damage + your tear damage on hit and leaves a damage over time poison effect that does 3 times your tear damage per tick
Synergizes with tear modifying items such as My Reflection or Tiny Planet
Has a chance to drop from the Sloth miniboss fight
Counts as 1 of 3 poison items needed towards the Bob transformation
Type: Active
Recharge Time: 2 rooms
Item Pool: Item Room, Sloth Miniboss
Teleport
ItemID: 44
"Teleport!"
Quality: 0
Teleports Isaac to a random location on the map
Can't be used to teleport to the I AM ERROR room
Type: Active
Recharge Time: 2 rooms
Item Pool: Item Room
Yum Heart
ItemID: 45
"Reusable regeneration"
Quality: 1
Heals Isaac for one whole red heart
Maggy starts with this item
When used as the Keeper, one coin HP is restored
Has a chance to drop from the Super Lust miniboss fight
Type: Active
Recharge Time: 4 rooms
Item Pool: Item Room, Super Lust Miniboss
Lucky Foot
ItemID: 46
"Luck up"
Quality: 2
+1.0 Luck Up
Better chance to win while gambling at the Shell Game and Fortune Telling Machine
Higher chance to get a random drop after clearing a room
Converts all negative pills into their positive counterparts. Doesn't affect neutral ones and pills remain unidentified
Type: Passive
Item Pool: Item Room, Beggar
Doctor's Remote
ItemID: 47
"Reusable air strike"
Quality: 1
A target is placed on the floor which can be controlled. After a few seconds a huge missile hits the target and deals 20x your tear damage to anything nearby
Essentially a one-time use of the Epic Fetus item
Type: Active
Recharge Time: 2 rooms
Item Pool: Item Room
Cupid's Arrow
ItemID: 48
"Piercing shots"
Quality: 3
Isaac's tears now have a piercing effect which allows them to travel through enemies instead of breaking on hit
Type: Passive
Item Pool: Item Room
Shoop Da Whoop!
ItemID: 49
"BLLLARRRRGGG!"
Quality: 2
When used, fires a high damage laser in a straight line across the room in a similar way to Brimstone
The laser deals damage equal to double your tear damage. The laser hits up to 13 times if an enemy stays inside it for the duration
Has a chance to drop from the Envy and Super Envy miniboss fights
Type: Active
Recharge Time: 2 rooms
Item Pool: Item Room, Envy Miniboss, Super Envy Miniboss
Steven
ItemID: 50
"DMG up"
Quality: 3
+1 Damage Up
Can only be dropped by the Steven boss
Unlock this item by beating the Basement 40 times and defeating the Steven boss
Type: Passive
Item Pool: Steven Boss
Pentagram
ItemID: 51
"DMG up"
Quality: 3
+1.0 Damage Up
+10% chance of a devil/angel room opening while held
A second Pentagram will give an extra +5% chance
Counts as 1 of 3 evil items needed towards the Leviathan transformation
Type: Passive
Item Pool: Boss Room, Curse Room, Devil Room, Demon Beggar, Crane Game
Dr. Fetus
ItemID: 52
"???"
Quality: 4
Instead of tears, Isaac now shoots bombs from his eyes, which explode dealing damage to anything nearby
Bomb damage = damage * 10
Tears Down (Tear delay * 2.5)
Bombs will also synergize with other bomb items and tear modifiers, including Sad Bombs, Mr. Mega and many more
Bombs grow larger or smaller with tear size modifiers and are immune to knockback from their own explosions
Unlock this item by beating Mom's Heart 9 times
Type: Passive, Tear Modifier
Item Pool: Item Room
Magneto
ItemID: 53
"Item snatcher"
Quality: 1
Causes pickups on the floor move towards the player
Works across pits, but not through Key blocks
Chests up to 2 tiles away from Isaac open automatically. Spiked chests are opened without damaging Isaac. Locked chests and stone chests are not opened and still require a key/bomb
Type: Passive
Item Pool: Item Room
Treasure Map
ItemID: 54
"Full visible map"
Quality: 2
Reveals the entire map for every floor except the secret room locations
Does not show the icons for any unexplored rooms
Can still help you to guess which direction the boss room is in, due to the fact that the Boss Room is usually in the room furthest away from the first room
Type: Passive
Item Pool: Shop, Beggar
Mom's Eye
ItemID: 55
"Eye in the back of your head"
Quality: 1
Isaac has a random chance to fire another tear out the back of his head
The chance to fire the second tear can improve based on your luck stat and will always activate at +5 Luck
At +0 luck theres a ~50% chance for this effect to activate
Synergizes very well with a lot of items. If used with Brimstone you have a 100% chance to fire a laser out the back of your head
Counts as 1 of 3 mom items needed towards the Mom transformation
Type: Passive, Tear Modifier
Item Pool: Item Room, Challenge Room, Mom's Chest
Lemon Mishap
ItemID: 56
"Oops..."
Quality: 0
When used, drops a pool of 'lemonade' on the floor which damages any enemies that come into contact with it for 8 damage per tick
Type: Active
Recharge Time: 2 rooms
Item Pool: Item Room
Distant Admiration
ItemID: 57
"Attack fly"
Quality: 2
Gives Isaac an orbiting fly which deals 5 contact damage to enemies per tick
Counts as 1 of 3 fly items needed towards the Beelzebub transformation
Type: Passive, Orbital
Item Pool: Item Room, Key Beggar
Book of Shadows
ItemID: 58
"Temporary invincibility"
Quality: 3
Gives the player an invulnerability effect which lasts for a 10 seconds
Can be used to get free hits on the Blood Donation machines and Devil Beggars
Counts as 1 of 3 book items needed towards the Bookworm transformation
Type: Active
Recharge Time: 3 rooms
Item Pool: Item Room, Library
The Ladder
ItemID: 60
"Building bridges"
Quality: 1
Allows Isaac to walk over gaps with a width of one tile
Type: Passive
Item Pool: Shop
Charm of the Vampire
ItemID: 62
"Kills heal"
Quality: 1
+0.3 Damage Up
Heals half a heart after every 13 enemies killed
Works with the Keeper for restoring coin HP
Type: Passive
Item Pool: Item Room
The Battery
ItemID: 63
"Stores energy"
Quality: 2
All spacebar items can now be 'overcharged', allowing them to be charged up twice instead of once
The extra charges appear in yellow on top of the normal green bars
This item works with self-recharging items
Type: Passive
Item Pool: Shop
Steam Sale
ItemID: 64
"50% off"
Quality: 2
Items in the shop are now -50% off
15c items are reduced to 7c. 5c pickups become 3c. 3c pickups become 2c
Taking more than 1 steam sale reduces the price of all items even further
This item is called Steamy Sale on PS4, PS Vita, Xbox One and Switch versions, probably due to copyright reasons
Type: Passive
Item Pool: Shop, Greed Miniboss, Shopkeeper
Anarchist Cookbook
ItemID: 65
"Summon bombs"
Quality: 1
Spawns 6 troll bombs at random locations around the room
Bombs are effected by other passive bomb items
Has a chance to drop from the Pride miniboss fight
Counts as 1 of 3 book items needed towards the Bookworm transformation
Type: Active
Recharge Time: 3 rooms
Item Pool: Item Room, Library, Pride Miniboss
The Hourglass
ItemID: 66
"Temporary enemy slowdown"
Quality: 1
When used, slows down all enemies in the current room and their projectiles for about 8 seconds
Type: Active
Recharge Time: 2 rooms
Item Pool: Item Room
Sister Maggy
ItemID: 67
"Friends 'till the end"
Quality: 1
A familiar which follows Isaac around and shoots blood tears that deal 5 damage
The tears appear red but have no additional damage
Sister Maggy fires tears at a rate of 1 tear per second
Counts as 1 of 3 familiar items needed towards the Conjoined transformation
Type: Passive, Familiar
Item Pool: Item Room, Devil Room
Technology
ItemID: 68
"Laser tears"
Quality: 3
Isaac's tears are replaced with a laser that has unlimited range and can only fire at right angles
Lasers travel through enemies but not obstacles in the room
Synergizes with most items that affect how many tears you fire (20/20, Mutant Spider etc.) or the path they take (My Reflection, Tiny Planet etc.)
Type: Passive, Tear Modifier
Item Pool: Item Room
Chocolate Milk
ItemID: 69
"Charge shots"
Quality: 3
Isaac can now charge shots for more damage by holding down the fire button
At full charge, your tears do 4 times more damage
Tears fired at the minimum possible charge do roughly 1/3 of your normal damage
You can spam the fire button to rapid fire, however the overall damage per second will be low
Tears down: Delay * 2.5
Type: Passive, Tear Modifier
Item Pool: Item Room
Growth Hormones
ItemID: 70
"DMG up + speed up"
Quality: 3
+1.0 Damage Up
+0.2 Speed Up
Counts as 1 of 3 syringe items needed towards the Spun transformation
Type: Passive
Item Pool: Boss Room, Demon Beggar
Mini Mush
ItemID: 71
"Speed + range up"
Quality: 2
+0.3 Speed Up
+1.5 Range Up
Causes Isaac to shrink in size (including hitbox slightly)
Can be dropped when exploding mushrooms in the environment that are usually found in the Caves/Catacombs and in secret rooms
Counts as 1 of 3 mushroom items needed towards the Fun Guy transformation
Type: Passive
Item Pool: Item Room
Rosary
ItemID: 72
"Faith up"
Quality: 2
+3 Soul Hearts
+0.5 Tears Up
Adds several instances of The Bible item into all item pools
Counts as 1 of 3 angel items needed towards the Seraphim transformation
Type: Passive
Item Pool: Item Room, Angel Room
Cube of Meat
ItemID: 73
"Gotta meat em all"
Quality: 2
An orbital which blocks shots and damages enemies it comes into contact with for 7 damage per tick
Exclusively drops from one of the horsemen bosses
2 cubes of meat transform the orbital into a meat head which fires blood tears which deal 3.5 damage each
3 cubes of meat transform it into a meat boy familiar that walks around and deals 3.5 contact damage per tick to enemies
4 cubes of meat cause the meat boy familiar to grow in size and do 5.5 damage per tick instead
Any further cubes of meat past 4 will start the cycle again
Unlock this item by beating Mom for the first time
Type: Passive
Item Pool: None (Horsemen boss only)
A Quarter
ItemID: 74
"+25 coins"
Quality: 0
+25 Coins
Has a very small chance to drop after destroying one of the pots that appear in the Basement and Cellar floors
Has a chance to drop from the Super Greed miniboss fight
Unlock this item by beating Mom's Heart 8 times
Type: Passive
Item Pool: Devil Room, Gold Chest, Super Greed Miniboss
PhD
ItemID: 75
"Better pills"
Quality: 2
Converts most negative pills into their positive counterparts, e.g. Stat Down becomes Stat Up. Bad Trip becomes Balls of Steel. Amnesia becomes I Can See Forever etc
Pills are identified before using them
Drops one pill on pickup
Heals for 2 full red hearts
Adds 0-2 coins to the payout when you use a Blood Donation machine or IV Bag
Type: Passive
Item Pool: Item Room, Shop
X-Ray Vision
ItemID: 76
"I've seen everything"
Quality: 2
Reveals the entrance to secret rooms and automatically opens the hole, removing the need for bombs to enter
Type: Passive
Item Pool: Item Room
My Little Unicorn
ItemID: 77
"Temporary badass"
Quality: 1
Gives Isaac invincibility and +0.28 Speed for 6 seconds
While active you cannot fire tears, but running into enemies will deal 40 contact damage per second
Allows free hits on the Blood Donation machines and devil beggars
Type: Active
Recharge Time: 4 rooms
Item Pool: Item Room
Book of Revelations
ItemID: 78
"Reusable soul protection"
Quality: 3
Upon use, gives Isaac an extra Soul heart
Using this item gives you a higher chance of finding a horsemen boss at the end of the floor
+17.5% chance of a Devil Deal opening after the boss fight
Counts as 1 of 3 book items needed towards the Bookworm transformation
Unlock this item by beating one of the horsemen bosses for the first time
Type: Active
Recharge Time: 6 rooms
Item Pool: Item Room, Library
The Mark
ItemID: 79
"DMG up"
Quality: 3
+1.0 Damage Up
+0.2 Speed Up
+1 Soul Heart
Counts as 1 of 3 evil items needed towards the Leviathan transformation
Type: Passive
Item Pool: Curse Room, Devil Room, Demon Beggar
The Pact
ItemID: 80
"DMG + tears up"
Quality: 3
+0.5 Damage Up
+0.7 Tears Up
+2 Black Hearts
Counts as 1 of 3 evil items needed towards the Leviathan transformation
Type: Passive
Item Pool: Devil Room, Curse Room, Demon Beggar
Dead Cat
ItemID: 81
"9 lives"
Quality: 3
Isaac's health is set to 1 and he also gains 9 extra lives
Each time Isaac dies, he will respawn with 1 Health
Has a chance to drop from the Super Pride mini boss
The floating Dead Cat head that follows you will disappear when you are on your last life (Very useful for The Lost)
Counts as 1 of 3 cat items needed towards the Guppy transformation
Type: Passive
Item Pool: Devil Room, Curse Room, Red Chest, Super Pride Miniboss
Lord of the Pit
ItemID: 82
"Demon wings"
Quality: 3
Gives Isaac demon wings and the ability to fly
+0.3 Speed Up
Counts as 1 of 3 evil items needed towards the Leviathan transformation.
Type: Passive
Item Pool: Devil Room, Demon Beggar
The Nail
ItemID: 83
"Temporary demon form"
Quality: 2
Each use of this item gives +0.7 Damage Up, -0.18 Speed Down and the ability to destroy most obstacles for the current room.
Each use also gives half a black heart, however this is stays between rooms unlike the other effects
Allows Isaac to deal 40 contact damage to enemies for the current room. Does not prevent Isaac from taking contact damage
All the above effects are only active when the item is used for the current room
Counts as 1 of 3 evil items needed towards the Leviathan transformation
Unlock this item by beating the Boss Rush with Azazel
Type: Active
Recharge Time: 6 rooms
Item Pool: Devil Room, Demon Beggar
We Need To Go Deeper
ItemID: 84
"Reusable level skip"
Quality: 2
Spawns a trapdoor at Isaac's feet which allows him to travel to the next floor
Digging in certain spots with objects or markings on the floor will guarantee a crawlspace once per floor
In Sheol, Cathedral, Chest and Dark Room this item either opens a Crawl Space, or does nothing
Cannot spawn a trapdoor directly infront of a secret room entrance
Can destroy rocks if used when Isaac is flying over a rock
Type: Active
Recharge Time: 6 rooms
Item Pool: Secret Room, Devil Room
Deck of Cards
ItemID: 85
"Reusable card generator"
Quality: 2
Gives Isaac a random tarot card on use
Counts as 1 of 3 astrology items needed in the same run to unlock Planetariums
Type: Active
Recharge Time: 6 rooms
Item Pool: Item Room, Shop
Monstro's Tooth
ItemID: 86
"Summon monstro"
Quality: 1
When used, spawns a Monstro which will jump on a random enemy in the room, dealing 120 damage and destroying nearby obstacles
Unlock this item by beating the Basement II for the first time
Type: Active
Recharge Time: 3 rooms
Item Pool: Item Room
Loki's Horns
ItemID: 87
"Cross tears"
Quality: 1
Everytime you fire a tear, there is a chance that you will also fire three more tears in all cardinal directions
The chance to fire 4-way tears is affected by your luck stat and at +15 Luck it will activate every time
At +0 luck the effect has a 30% chance to activate
Unlock this item by beating Lokii for the first time
Type: Passive, Tear Modifier
Item Pool: Item Room, Demon Beggar
Little Chubby
ItemID: 88
"Attack buddy"
Quality: 2
A familiar that follows Isaac and charges forwards, dealing 3.5 damage per tick to any enemies it comes into contact with
Unlock this item by beating the Caves II for the first time
Type: Passive, Familiar
Item Pool: Item Room
Spider Bite
ItemID: 89
"Slow effect"
Quality: 2
Tears now have a chance of slowing enemies and their projectiles for 2.5 seconds
The chance to slow enemies is affected by your luck stat and at +15 Luck it will activate every time
Type: Passive
Item Pool: Item Room
The Small Rock
ItemID: 90
"DMG up"
Quality: 3
+1.0 Damage Up
+0.2 Tears Up
-0.2 Speed Down
Has a chance to drop when exploding a tinted rock
Unlock this item by destroying 100 tinted rocks
Type: Passive
Item Pool: None (Tinted rock only)
Spelunker Hat
ItemID: 91
"See-through doors"
Quality: 2
Reveals adjacent rooms up to 2 rooms away, this includes revealing if you're next to a Secret Room or Super Secret Rooms
Gives Isaac a slight glow when Curse of Darkness is active
Blocks damage from projectiles falling from above
Type: Passive
Item Pool: Item Room
Super Bandage
ItemID: 92
"+2 hearts"
Quality: 2
+1 HP Up
+2 Soul Hearts
Heals one red heart container when picked up
Unlock this item by making a Super Bandage Girl
Type: Passive
Item Pool: Item Room, Boss Room
The Gamekid
ItemID: 93
"Temporary Man-Pac"
Quality: 1
When used Isaac transforms into pacman, which makes him invincible for 6 seconds and does 40 contact damage to enemies per chomp
Everytime you 'eat' 2 enemies, you regain 1/2 heart of red health
You can't shoot tears while the effect is active
Unlock this item by visiting 10 arcades
Type: Active
Recharge Time: 4 rooms
Item Pool: Item Room
Sack of Pennies
ItemID: 94
"Gives money"
Quality: 1
A bag that floats around following Isaac and drops a random coin every 2 rooms
Unlock this item by beating Isaac with Cain
Type: Passive, Familiar
Item Pool: Item Room
Robo-Baby
ItemID: 95
"Friends till the bzzzttt"
Quality: 1
A familiar which follows Isaac and shoots lasers, similar to the Technology item
Robo-Baby's laser is spectral and piercing (It will pass through rocks and objects in the environment)
Robo-Baby's lasers deal 3.5 damage per hit
Counts as 1 of 3 familiar items needed towards the Conjoined transformation.
Type: Passive, Familiar
Item Pool: Item Room
Little C.H.A.D
ItemID: 96
"Gives kisses"
Quality: 2
A familiar which follows Isaac and drops half a red heart every 3 rooms
Unlock this item by beating the Caves 30 times and defeating C.H.A.D
Type: Passive, Familiar
Item Pool: Item Room, C.H.A.D. Boss
The Book of Sin
ItemID: 97
"Reusable item generator"
Quality: 2
Spawns a random pickup on the floor
Any pickups are possible from this item, including Bombs, hearts, keys, coins, pills, batteries, tarot cards, runes etc
Doesn't produce microbatteries, only regular sized ones and rarely golden/mega batteries
Counts as 1 of 3 book items needed towards the Bookworm transformation
Unlock this item by beating each of the Seven Sins once
Type: Active
Recharge Time: 4 rooms
Item Pool: Item Room, Library, Devil Room
The Relic
ItemID: 98
"Soul generator"
Quality: 3
A blue cross that follows Isaac and drops a soul heart every 7 or 8 rooms
Unlock this item by beating the Isaac boss with Maggy
Type: Passive, Familiar
Item Pool: Item Room, Angel Room
Little Gish
ItemID: 99
"Sticky friend"
Quality: 2
A familiar that follows Isaac and fires black tar tears, which slow enemy movement and projectile speed for a few seconds
Little Gish's tears do 3.5 damage
Little Gish fires tears at a rate of 1 tear per second
A Guaranteed drop from the Gish boss fight
Unlock this item by beating the Depths 20 times and killing the Gish boss
Type: Passive, Familiar
Item Pool: Item Room, Gish Boss
Little Steven
ItemID: 100
"Psychic friend"
Quality: 2
A familiar that follows Isaac and fires homing tears that deal 3.5 damage each
Has a high chance to drop from the Steven boss fight
Little Steven fires tears at a rate of 1 tear per second with a slightly longer range than other familiars
Counts as 1 of 3 familiar items needed towards the Conjoined transformation
Unlock this item by killing the Steven boss for the first time
Type: Passive, Familiar
Item Pool: Item Room, Steven Boss
The Halo
ItemID: 101
"All stats up"
Quality: 2
+1 HP Up
+0.3 Damage Up
+0.2 Tears Up
+0.38 Range Up
+0.3 Speed Up
Heals one red heart container when picked up
Counts as 1 of 3 angel items needed towards the Seraphim transformation
Unlock this item by killing Mom (Mom's Foot or Mom's Heart) using The Bible
Type: Passive
Item Pool: Item Room, Angel Room
Mom's Bottle of Pills
ItemID: 102
"Reusable pill generator"
Quality: 1
When used, gives Isaac a random pill
Counts as 1 of 3 mom items needed towards the Mom transformation
Type: Active
Recharge Time: 6 rooms
Item Pool: Item Room, Shop, Challenge Room, Beggar, Demon Beggar, Mom's Chest
The Common Cold
ItemID: 103
"Poison damage"
Quality: 1
Tears now have a random chance to apply a poison effect, causing double your tear damage per tick to enemies over time
The chance to fire poison shots is affected by your luck stat and at +12 Luck it will activate every time
Type: Passive
Item Pool: Item Room
The Parasite
ItemID: 104
"Split shot"
Quality: 3
Isaac's tears now split into two upon contact with enemies or the environment
Tears that split off from the main tear do less damage (tear damage * 0.5)
Tears can keep splitting if they still have range and damage above 1
Unlock this item by collecting two of the following items: Bob's Rotten Head, Dead Cat, Cricket's Head, Tammy's Head
Type: Passive
Item Pool: Item Room
The D6
ItemID: 105
"Reroll your destiny"
Quality: 4
When used, replaces all pedestal items in the current room with another random item. Re-rolled items pick from the current room's item pool
Isaac starts with this item after it is unlocked
Unlock this item by defeating the Isaac boss with Blue Baby
Type: Active
Recharge Time: 6 rooms
Item Pool: Item Room
Mr. Mega
ItemID: 106
"Blast damage"
Quality: 2
+5 Bombs
Bombs now do 185 damage (up from 100) and have a larger blast radius
Can be found in the secret room
Has a chance to drop from the Super Wrath miniboss fight
Unlock this item by destroying 10 tinted rocks
Type: Passive
Item Pool: Item Room, Bomb Beggar, Super Wrath Miniboss
Pinking Shears
ItemID: 107
"Cut and run"
Quality: 2
Cuts Isaac's head from his body for the current room, allowing him to fly and leaving the decapitated body to run around attacking enemies for 5.5 damage per tick
Type: Active
Recharge Time: 4 rooms
Item Pool: Item Room
The Wafer
ItemID: 108
"Damage resistance"
Quality: 4
All damage taken is reduced to half a heart
Damaged reduction is reduced from every source in the game except Devil Deals and health down pills
Does not prevent death (i.e. Suicide King or using The Bible on Isaac, ??? or Satan)
The Wafer becomes most effective in the Womb and beyond where enemies all deal a whole heart of damage
The Wafer causes the Sharp Plug item to only cost 1/2 a heart per use
Has no effect with the Keeper - there's no such thing as half a coin health point
Type: Passive
Item Pool: Item Room, Angel Room
Money = Power
ItemID: 109
"$$$ = DMG"
Quality: 3
+0.04 Damage Up for every coin you currently have
At 99 coins this item gives +3.96 Damage Up
+0.04 per coin is the amount added before the damage formula is calculated, as this is the only way to show a consistent amount of damage given. You may see more or less than this on the Found HUD overlay, however this number varies based on your other damage increasing items
Type: Passive
Item Pool: Item Room, Devil Room
Mom's Contacts
ItemID: 110
"Freeze effect"
Quality: 3
Tears now have a random chance to freeze enemies in place
The chance to freeze enemies is affected by your luck stat
+0.38 Range Up
Chance to activate increases with luck, up to around 50% chance at +20 luck
Counts as 1 of 3 mom items needed towards the Mom transformation
Unlock this item by collecting 3 'Mom' items in one playthrough
Type: Passive
Item Pool: Item Room, Challenge Room, Mom's Chest
The Bean
ItemID: 111
"Toot on command"
Quality: 0
Upon use, this item causes Isaac to fart and poison any enemies in close proximity
The Bean deals 5 damage, then poisons enemies for 6 total ticks of damage
The poison deals your current tear damage per tick
Type: Active
Recharge Time: 1 room
Item Pool: Item Room, Beggar
Guardian Angel
ItemID: 112
"Extra protection"
Quality: 2
An orbital which does 7 contact damage per tick, blocks shots and increases the speed of all other orbitals
Counts as 1 of 3 angel items needed towards the Seraphim transformation
Counts as 1 of 3 familiar items needed towards the Conjoined transformation.
Unlock this item by beating Satan with Maggy
Type: Passive, Orbital
Item Pool: Angel Room
Demon Baby
ItemID: 113
"Auto-turret friend"
Quality: 2
A familiar which follows Isaac and automatically fires tears that deal 3 damage each at any enemies in close range
Counts as 1 of 3 familiar items needed towards the Conjoined transformation.
Unlock this item by beating the Dark Room with Azazel
Type: Passive, Familiar
Item Pool: Item Room, Devil Room
Mom's Knife
ItemID: 114
"Stab stab stab"
Quality: 4
Tears are replaced with a knife which can be charged and thrown in a boomerang style action
The knife can also do damage without being thrown as a close range melee weapon
When used as a melee weapon, Mom's Knife deals your tear damage * 2 per tick
At the furthest point from Isaac the knife deals your tear damage * 6
Counts as 1 of 3 mom items needed towards the Mom transformation
Unlock this item by beating Satan with Isaac
Type: Passive, Tear Modifier
Item Pool: Item Room, Devil Room, Challenge Room, Mom's Chest
Ouija Board
ItemID: 115
"Spectral tears"
Quality: 2
Gives Isaac spectral tears which allows them to travel through objects in the environment (i.e. rocks)
+0.4 Tears Up
Type: Passive
Item Pool: Item Room, Devil Room
9 Volt
ItemID: 116
"Quicker charge"
Quality: 2
Automatically gives you 1 bar of charge after using your spacebar item
Fully recharges your current spacebar item when picked up
Any items which are normally a 1 room recharge are now timed instead
Type: Passive
Item Pool: Shop
Dead Bird
ItemID: 117
"Protective buddy"
Quality: 0
When Isaac takes damage, the dead bird will spawn and attack nearby enemies in the current room for 2 damage per tick
Eve starts with this item
Type: Passive, Familiar
Item Pool: Item Room
Brimstone
ItemID: 118
"Blood laser barrage"
Quality: 4
Tears are replaced with the ability to charge and fire a powerful laser that travels in a straight line across the room, dealing a lot of damage (tear damage hits for 9 ticks per laser) to any enemies it comes into contact with
Does not directly affect your Damage stat but hits enemies 9 times per charge
Synergizes very well with a lot of items including Tammy's Head, Tiny Planet, Inner Eye (Triple Shot), Mutant Spider (Quad Shot) and many others
If you somehow manage to get a second Brimstone, the laser becomes massive and deals double damage
Type: Passive, Tear Modifier
Item Pool: Devil Room
Blood Bag
ItemID: 119
"HP up"
Quality: 2
+1 HP Up
+0.3 Speed Up
Heals for 5 full red hearts
Has a chance to drop while playing any Blood Donation machine
Unlock this item by playing the Blood Donation machine 30 times
Type: Passive
Item Pool: None (Blood Donation machine only)
Odd Mushroom (Thin)
ItemID: 120
"Fire rate up"
Quality: 2
Gives you a high rate of fire in exchange for a damage down
+1.7 Tears Up
+0.3 Speed Up
Damage Down (damage * 0.9 - 0.4)
Counts as 1 of 3 mushroom items needed towards the Fun Guy transformation
Type: Passive
Item Pool: Item Room, Secret Room
Odd Mushroom (Large)
ItemID: 121
"DMG up"
Quality: 2
+1 HP Up
+1.0 Damage Up
+0.38 Range Up
-0.2 Speed Down
Heals one red heart container when picked up
Counts as 1 of 3 mushroom items needed towards the Fun Guy transformation
Type: Passive
Item Pool: Item Room, Secret Room
Whore of Babylon
ItemID: 122
"Curse up"
Quality: 2
When you only have half a red heart remaining or less, you enter a curse state which adds +1.5 damage and +0.3 speed
When playing as Eve, this item activates with one FULL heart remaining or less AND also removes her 0.75 damage multiplier, raising it up to 1.0
The effect is permanently active for characters with no red hearts (e.g. Blue Baby, The Lost)
One of Eve's starting items
Type: Passive
Item Pool: Devil Room, Demon Beggar
Monster Manual
ItemID: 123
"Temporary buddy generator"
Quality: 1
When used, gives a random familiar for the entire floor
It can spawn familiars you haven't unlocked yet!
Type: Active
Recharge Time: 6 rooms
Item Pool: Item Room, Devil Room, Library
Dead Sea Scrolls
ItemID: 124
"It's a mystery"
Quality: 1
Upon use, the dead sea scrolls gives a random active item effect
An item that can be found in the Angel room
The name of the effect given is displayed when used.
Cannot give the Kamikaze effect
Type: Active
Recharge Time: 2 rooms
Item Pool: Item Room, Angel Room
Bobby - Bomb
ItemID: 125
"Friends till the end"
Quality: 2
+5 Bombs
All of Isaac's bombs now having a homing effect when placed on the floor
Type: Passive
Item Pool: Item Room, Bomb Beggar
Razor Blade
ItemID: 126
"Feel my pain"
Quality: 0
When used, deals damage to Isaac in exchange for +1.2 damage up which lasts for the current room
This item takes 1 full heart of damage per use, and will take red hearts first before any other
Eve starts with this item after donating 439 coins to the Greed Donation Machine
Unlock this item by beating Satan with Eve
Type: Active
Recharge Time: Instant
Item Pool: Item Room, Curse Room, Demon Beggar
Forget Me Now
ItemID: 127
"I don't remember..."
Quality: 3
Upon use, this item refreshes the current floor with brand new rooms, monsters and items, as if you had entered a new floor
Unlock this item by beating Satan with Blue Baby
Type: Active
Recharge Time: Instant (One time use)
Item Pool: Item Room, Secret Room, Devil Room, Demon Beggar
Forever Alone
ItemID: 128
"Attack fly"
Quality: 1
An orbiting fly which deals 2 contact damage per tick to enemies
Counts as 1 of 3 fly items needed towards the Beelzebub transformation
Type: Passive, Orbital
Item Pool: Item Room
Bucket of Lard
ItemID: 129
"HP up"
Quality: 1
+2 Health Up
-0.2 Speed Down
Has a chance to drop from the Super Gluttony miniboss fight
Type: Passive
Item Pool: Item Room, Super Gluttony Miniboss
A Pony
ItemID: 130
"Flight + dash attack"
Quality: 2
Allows Isaac to fly while the Pony is held
Sets your speed stat to 1.5 if it isn't already that high
When the active attack is used, Isaac will dash across the screen dealing scaling contact damage to anything he hits (damage * 4 + 28)
Drops from the Headless Horseman boss fight
Type: Active
Recharge Time: 2 rooms
Item Pool: None (Headless horseman only)
Bomb Bag
ItemID: 131
"Gives bombs"
Quality: 2
A bag of bombs that will drop a bomb pickup every 2 rooms
Unlock this item by beating Satan with Cain
Type: Passive, Familiar
Item Pool: Item Room
A Lump of Coal
ItemID: 132
"My Xmas present"
Quality: 3
Tears gain a damage up and increase in size based on the distance they travel
The length of a normal room roughly gives +6 damage, but this can be higher with double rooms or Tiny Planet
This item synergises with beam items such as Brimstone and Tech, allowing them to do more damage the further away the enemy is
Type: Passive
Item Pool: None (Krampus only)
Guppy's Paw
ItemID: 133
"Soul converter"
Quality: 3
When used, removes one heart container and gives you 3 soul hearts
Bone hearts cannot be converted
Counts as 1 of 3 cat items needed towards the Guppy transformation
Type: Active
Recharge Time: Instant
Item Pool: Devil Room, Curse Room, Red Chest
Guppy's Tail
ItemID: 134
"Cursed?"
Quality: 2
Gives a 1/3 chance for room clear rewards to become a normal or locked chest, and a 1/3 chance to reward nothing at all
Doesn't affect coins dropped after waves in Greed Mode
Counts as 1 of 3 cat items needed towards the Guppy transformation
Type: Passive
Item Pool: Devil Room, Curse Room, Red Chest
IV Bag
ItemID: 135
"Portable blood bank"
Quality: 1
Upon use, the IV Bag takes half a red heart and spawns 1-3 coins (the same effect as a blood donation machine)
Can drop from a blood donation machine after playing it
In the Womb and beyond this deals 1 full heart of damage
If no red hearts exist, other types of hearts are consumed instead
With the Keeper this is changed to spawning 0-1 coins per use instead
Type: Active
Recharge Time: Instant
Item Pool: None (Blood donation machine only)
Best Friend
ItemID: 136
"Friends 'till the end"
Quality: 1
Places a decoy on the floor which attracts enemies and explodes after a period of time
When it explodes, it deals 185 damage to everything in radius (Same damage as Mr Mega bombs)
Type: Active
Recharge Time: 3 rooms
Item Pool: Item Room
Remote Detonator
ItemID: 137
"Remote bomb detonation"
Quality: 1
+5 Bombs
Bombs no longer automatically explode and will only do so when you activate the remote detonator
Can be used to detonate Dr. Fetus bombs early
Type: Active
Recharge Time: Instant
Item Pool: Item Room, Shop, Bomb Beggar
Stigmata
ItemID: 138
"DMG + HP up"
Quality: 2
+1 HP Up
+0.3 Damage Up
Heals one red heart container when picked up
Type: Passive
Item Pool: Item Room
Mom's Purse
ItemID: 139
"More trinket room"
Quality: 2
Isaac can now hold two trinkets at the same time
Drops a random trinket on the floor when picked up
Allows you to pick up more trinkets while also holding The Tick
Counts as 1 of 3 mom items needed towards the Mom transformation
Type: Passive
Item Pool: Shop, Mom's Chest
Bob's Curse
ItemID: 140
"Poison bombs"
Quality: 1
+5 Bombs
Isaac's bombs now poison nearby enemies and leave behind a gas cloud that poisons enemies that move through it. Poisoned enemies take 4 or 6 damage per tick for a few seconds
Has a chance to drop from the Super Sloth miniboss fight
Counts as 1 of 3 poison items needed towards the Bob transformation
Type: Passive
Item Pool: Item Room, Super Sloth Miniboss, Bomb Beggar
Pageant Boy
ItemID: 141
"Ultimate grand supreme"
Quality: 0
Spawns 7 random coins around Isaac on the floor
Isaac wears a pink crown on his head
Type: Passive
Item Pool: Boss Room
Scapular
ItemID: 142
"You have been blessed"
Quality: 2
Once per room when you are damaged down to your final half a heart, you gain 1 soul heart
Re-entering a room allows this effect to be triggered again
Scapular won't grant its soul heart if the player is attempting to proc it with certain heart donation mechanics (such as IV Bag)
Counts as 1 of 3 angel items needed towards the Seraphim transformation.
Type: Passive
Item Pool: Item Room, Angel Room
Speed Ball
ItemID: 143
"Speed + shot speed up"
Quality: 2
+0.3 Speed Up
+0.2 Shot Speed Up
Counts as 1 of 3 syringe items needed towards the Spun transformation
Type: Passive
Item Pool: Item Room, Boss Room, Demon Beggar
Bum Friend
ItemID: 144
"He's Greedy"
Quality: 1
A beggar who follows Isaac around and automatically picks up nearby coins
After picking up 6 coins he will drop a random pickup, e.g. hearts, keys, bombs, coins, pills, cards, trinkets, batteries etc
After the first drop, he has a 67% chance to drop a pickup after 3 coins and a 33% chance to drop a pickup after 4 coins
Bum friend also has a chance to spawn items from the Beggar Item Pool
Counts as 1 of 3 bum items needed towards the Super Bum transformation
Type: Passive, Familiar
Item Pool: Item Room
Guppy's Head
ItemID: 145
"Reusable fly hive"
Quality: 2
When used, spawns between 2-4 blue flies
Blue Flies do double your tear damage
Counts as 1 of 3 cat items needed towards the Guppy transformation
Type: Active
Recharge Time: 1 room
Item Pool: Devil Room, Curse Room, Red Chest, Gold/Stone Chest
Prayer Card
ItemID: 146
"Reusable eternity"
Quality: 3
Gives Isaac an eternal heart when used
Taking an eternal heart to the next floor or collecting two on the same floor gives you an extra heart container
Type: Active
Recharge Time: 6 rooms
Item Pool: Item Room, Angel Room
Notched Axe
ItemID: 147
"Rocks didn't stand a chance"
Quality: 1
When activated, Isaac takes out the axe and gives you the ability to break rocks and damage enemies with it
It has a limited amount of uses per floor, decreasing with every hit that connects with a rock/enemy
Cannot break the stone blocks which appear in the environment
Creates bridges when breaking rocks next to pits
Type: Active
Recharge Time: At the start of each new floor
Item Pool: Shop, Crane Game
Infestation
ItemID: 148
"Fly revenge"
Quality: 0
When Isaac gets hit, 2-6 blue flies will randomly spawn
Blue Flies do double your tear damage
Counts as 1 of 3 fly items needed towards the Beelzebub transformation
Type: Passive
Item Pool: Item Room
Ipecac
ItemID: 149
"Explosive shots"
Quality: 4
Isaac's tears are replaced with explosive poison bombs, which will arc upwards and explode on contact with the floor, dealing huge damage and leaving a poison effect on enemies in range
Ipecac shots are given a flat +40 Damage on top of the normal 3.5 base damage
Tears Down (Tear delay * 2 + 10)
Ipecac explosion size scales with tear size
Shots will damage Isaac if he is in the blast radius when they explode
Counts as 1 of 3 poison items needed towards the Bob transformation
Unlock this item by beating Mom's Heart 6 times
Type: Passive, Tear Modifier
Item Pool: Item Room
Tough Love
ItemID: 150
"Tooth shot"
Quality: 3
Isaac has a random chance to fire a tooth shot instead of a tear sometimes
Teeth shots deal damage equal to your tear damage * 3.2
The chance to fire a tooth is affected by your luck stat and at +9 Luck it will activate every time
Synergizes well with some tear modifiers such as Ipecac, which causes it to do massive damage
Type: Passive
Item Pool: Item Room
The Mulligan
ItemID: 151
"They grow inside"
Quality: 3
Isaac has a 1/6 chance to spawn a blue fly when one of his tears hits an enemy
Blue Flies do double your tear damage
The chance to activate this effect is not changed with your Luck stat
Counts as 1 of 3 fly items needed towards the Beelzebub transformation
Type: Passive
Item Pool: Item Room
Technology 2
ItemID: 152
"Laser"
Quality: 2
Isaac now also has a laser with unlimited range which fires continuously, dealing damage 15 times per second
Tears continue to fire from your left eye at a rate of 2/3
The laser deals damage equal to 1/7th of your tear damage, but very rapidly
The laser can apply status effects (e.g. Poison) rapidly due to how often it hits
Does not apply a negative damage multiplier as it used to prior to Repentance
Type: Passive, Tear Modifier
Item Pool: Item Room
Mutant Spider
ItemID: 153
"Quad Shot"
Quality: 3
Tears now shoot 4 at a time (Quad Shot)
Tears Down significantly (Tear delay * 2.1 + 3)
Synergizes well with a lot of tear effects - e.g. with Brimstone you get 4 lasers
Counts as 1 of 3 spider items needed towards the Spider Baby transformation
Type: Passive, Tear Modifier
Item Pool: Item Room
Chemical Peel
ItemID: 154
"DMG up"
Quality: 2
+2 Damage Up for tears fired from Isaac's left eye
If playing as Cain or you have an item which modifies which eye you fire tears from, each shot has a 50% chance to do +2 Damage
Type: Passive
Item Pool: Item Room
The Peeper
ItemID: 155
"Plop!"
Quality: 2
Gives Isaac an eye companion that floats around the room and deals 8 damage per tick on contact with enemies
Damage from Isaac's left eye deal roughly +35% damage
Type: Passive, Familiar
Item Pool: Item Room
Habit
ItemID: 156
"Item martyr"
Quality: 2
When you take damage, this item recharges one room's worth of charge to your spacebar item
For example, with the D6 you would need to take damage 6 times to fully recharge it
Type: Passive
Item Pool: Shop, Angel Room
Bloody Lust
ItemID: 157
"RAGE!"
Quality: 2
Each time you take damage, you gain a damage up which lasts for the rest of the floor and turn a darker red colour each time
After taking 6 hits Bloody Lust doesn't give you any further damage increases
Damage given for each hit increases as follows: +0.5, +0.7, +0.9, +1.1, +1.3, +1.5
Samson starts with this item
Unlock this item by beating the Isaac boss with Samson
Type: Passive
Item Pool: Item Room, Devil Room
Crystal Ball
ItemID: 158
"I see my future"
Quality: 3
Upon use, reveals the map and drops either a soul heart or a random card/rune (50% chance for each)
It reveals the location of the secret room, however it doesn't reveal the Super secret room
Has a chance to drop from playing a fortune machine
Counts as 1 of 3 astrology items needed in the same run to unlock Planetariums
Guarantees a Planetarium if an item room has been skipped, otherwise +15% chance for Planetariums to spawn while held. After entering a Planetarium the chance goes back to 1%. The floor generation can fail and cause the guaranteed Planetarium to not spawn sometimes.
Type: Active
Recharge Time: 6 rooms
Item Pool: None (Fortune machine only)
Spirit of the Night
ItemID: 159
"Scary"
Quality: 3
Gives Isaac the ability to fly and spectral tears
Counts as 1 of 3 evil items needed towards the Leviathan transformation
Type: Passive
Item Pool: Devil Room, Demon Beggar
Crack The Sky
ItemID: 160
"Holy white death"
Quality: 2
Creates 5 beams of light from the sky that deal damage equal to your tear damage + 20 to any enemies which come into contact with them
The beams have a high chance to spawn on top of enemies where possible
Type: Active
Recharge Time: 4 rooms
Item Pool: Item Room
Ankh
ItemID: 161
"Eternal life?"
Quality: 1
Upon death, you respawn in the previous room as Blue Baby with three Soul hearts
This is a one time use item and all new heart containers will be soul hearts
Can be used to unlock some of Blue Baby's secrets before having the character available
Type: Passive
Item Pool: Item Room
Celtic Cross
ItemID: 162
"You feel blessed"
Quality: 1
Upon taking damage, you have a 20% chance to gain an invulnerability shield for 7 seconds
The chance to gain a shield is affected by your luck stat and at +27 Luck it will activate every time
Counts as 1 of 3 angel items needed towards the Seraphim transformation.
Unlock this item by beating the Chest with Maggy
Type: Passive
Item Pool: Item Room, Angel Room
Ghost Baby
ItemID: 163
"Spectral buddy"
Quality: 1
A familiar which follows Isaac and shoots spectral tears that deal 3.5 damage
Ghost Baby fires tears at a rate of 1 tear per second
Can drop while destroying skulls in the Depths and Necropolis floors
Counts as 1 of 3 familiar items needed towards the Conjoined transformation.
Type: Passive, Familiar
Item Pool: Item Room, Devil Room
The Candle
ItemID: 164
"Reusable flame"
Quality: 2
A spacebar item which allows Isaac to fire a blue flame that damages anything in its path for 23 damage per tick
Can cause up to a total of 276 potential damage
The flame destroys enemy shots, making it useful for bullet hell bosses
Unlock this item by donating 900 coins to the Shop
Type: Active
Recharge Time: Timed (A few seconds)
Item Pool: Shop
Cat-O-Nine-Tails
ItemID: 165
"Shot speed up + DMG up"
Quality: 3
+1.0 Damage Up
+0.23 Shot Speed Up
An item only found in the Boss room pool
Type: Passive
Item Pool: Boss Room
D20
ItemID: 166
"Reroll the basics"
Quality: 2
Upon use, re-rolls all pickup consumables in the current room into another random kind of pickup
This includes all types of pickup such as hearts, bombs, keys, coins, pills, tarot cards, chests, trinkets etc
Unlock this item by beating the Chest with Isaac
Type: Active
Recharge Time: 6 rooms
Item Pool: Item Room
Harlequin Baby
ItemID: 167
"Double shot buddy"
Quality: 1
A familiar which follows Isaac and shoots two normal tears at once in a V-shaped pattern
Each of Harlequin Baby's tears deal 4 damage
Harlequin Baby fires tears at a rate of 1 tear per second
Counts as 1 of 3 familiar items needed towards the Conjoined transformation
Type: Passive, Familiar
Item Pool: Item Room
Epic Fetus
ItemID: 168
"On-demand air strike"
Quality: 4
Tears now become missiles which deal huge damage to anything nearby
Missiles damage = damage * 20
This item places a controllable red target on the ground which will cause a missile to fall from the sky and hit it after a short period of time
Unlock this item by beating Challenge #19 (The Family Man)
Type: Passive, Tear Modifier
Item Pool: Secret Room
Polyphemus
ItemID: 169
"Mega tears"
Quality: 4
High Damage Up - (damage + 4) * 2
Tears Down significantly (Tear delay * 2.1 + 3)
If a tear kills an enemy, it continues to travel forward with the leftover damage
Type: Passive
Item Pool: Item Room
Daddy Longlegs
ItemID: 170
"Daddy's love"
Quality: 3
A shadow follows Isaac and stomps on enemies randomly, dealing 40 damage per stomp (2 damage ticks at 20 damage each)
Counts as 1 of 3 spider items needed towards the Spider Baby transformation.
Type: Passive, Familiar
Item Pool: Item Room
Spider Butt
ItemID: 171
"Mass enemy slowdown + damage"
Quality: 1
Upon use, does 10 damage to all enemies in the room and gives them a slowing effect for 4 seconds
Enemies killed by Spider Butt will spawn friendly blue spiders
Counts as 1 of 3 spider items needed towards the Spider Baby transformation
Type: Active
Recharge Time: 2 rooms
Item Pool: Item Room
Sacrificial Dagger
ItemID: 172
"My fate protects me"
Quality: 2
Gives Isaac an orbital knife that blocks shots and deals 15 damage per tick on contact with enemies
The highest damage orbital in the game, dealing 225 damage per second
Synergises very well with invulnerability items such as Book of Shadows
Unlock this item by beating the Chest with Eve
Type: Passive, Orbital
Item Pool: Item Room, Devil Room
Mitre
ItemID: 173
"You feel blessed"
Quality: 3
Gives a 33% chance of converting red heart drops into soul hearts
Counts as 1 of 3 angel items needed towards the Seraphim transformation
Type: Passive
Item Pool: Item Room, Angel Room
Rainbow Baby
ItemID: 174
"Random buddy"
Quality: 1
A familiar the follows Isaac and fires random tears
Rainbow Baby's tears can choose from any of the other familiars, such as homing, spectral, tar shots etc
Counts as 1 of 3 familiar items needed towards the Conjoined transformation.
Type: Passive, Familiar
Item Pool: Item Room
Dad's Key
ItemID: 175
"Opens all doors..."
Quality: 2
Upon use, opens all closed doors in the current room, including the ones which require a key to enter and secret room doors
Can be used to open the golden door that appears in the Dark Room or the Chest
Cannot be used to escape the Mom's Foot boss, open angel/devil rooms, or open the door to the Blue Womb floor
Unlock this item by collecting both Key Pieces #1 & #2 for the first time
Type: Active
Recharge Time: 2 rooms
Item Pool: Item Room, Key Beggar
Stem Cells
ItemID: 176
"HP up"
Quality: 1
+1 HP Up
+0.16 Shot Speed Up
Heals one red heart container when picked up
Type: Passive
Item Pool: Item Room, Boss Room
Portable Slot
ItemID: 177
"Gamble 24/7"
Quality: 0
Using the portable slot takes a coin and has a chance to give a pickup - similar to how the normal slot machines work
Type: Active
Recharge Time: Instant
Item Pool: Shop, Beggar
Holy Water
ItemID: 178
"Splash!"
Quality: 3
Spawns a familiar that follows Isaac and launches itself in the direction Isaac shoots
Upon hitting an enemy, it will deal 7 damage and shatter, creating a pool of damaging blue creep that also petrifies enemies that touch it
Once the pool disappears, the familiar will respawn and can be thrown again
Type: Passive, Familiar
Item Pool: Item Room, Angel Room
Fate
ItemID: 179
"Flight eternal"
Quality: 3
Gives Isaac an eternal heart and the ability to fly
Taking an eternal heart to the next floor or collecting two on the same floor gives you an extra heart container
Unlock this item by beating the Chest with Blue Baby
Type: Passive
Item Pool: Gold Chest
The Black Bean
ItemID: 180
"Toot on touch"
Quality: 0
Upon taking damage, Isaac will fart, causing all enemies in close proximity to become poisoned
Black Bean deals your tear damage for 6 ticks
Type: Passive
Item Pool: Item Room, Beggar
White Pony
ItemID: 181
"Flight + holy death"
Quality: 2
Allows Isaac to fly while the White Pony is held
While held, sets your speed stat to 1.5 if it isn't already that high. If your speed stat is already higher then that value is still used
Upon use, Isaac charges in the direction the pony is facing, becoming invulnerable during the charge and damaging enemies
While charging, Isaac spawns a trail of light beams that deal a lot of damage to enemies (damage * 4 + 10)
Drops from the Conquest boss fight
Type: Active
Recharge Time: 2 rooms
Item Pool: None (Conquest boss only)
Sacred Heart
ItemID: 182
"Homing shots + DMG up"
Quality: 4
Tears are now white, do a lot more damage and move slower across the screen with a homing effect
Health Up
Damage Up (damage * 2.3 + 1)
-0.4 Tears Down
-0.25 Shot Speed Down
Full red heart heal
Counts as 1 of 3 angel items needed towards the Seraphim transformation.
Type: Passive, Tear Modifier
Item Pool: Angel Room
Toothpicks
ItemID: 183
"Tears + shot speed up"
Quality: 3
+0.7 Tears Up
+0.16 Shot Speed Up
Does not increase your damage, simply makes your tears red
Type: Passive
Item Pool: Boss Room
Holy Grail
ItemID: 184
"Flight + HP up"
Quality: 3
+1 HP Up
Gives Isaac the ability to fly
Heals one red heart container when picked up
Counts as 1 of 3 angel items needed towards the Seraphim transformation
Type: Passive
Item Pool: Angel Room
Dead Dove
ItemID: 185
"Flight + spectral tears"
Quality: 3
Gives Isaac the ability to fly and spectral tears
An item only found in the Angel room
Counts as 1 of 3 angel items needed towards the Seraphim transformation
Type: Passive
Item Pool: Angel Room
Blood Rights
ItemID: 186
"Mass enemy damage at a cost"
Quality: 0
Upon use, takes away one full heart and deals 40 damage to the entire room
Shields and invincibility effects do not prevent damage when using this item
Using with Isaac's Heart previously prevented you from taking damage, however in Repentance this was fixed
Using this item as The Lost will instantly kill him, even if you have Holy Mantle active
Unlock this item by beating Satan with Samson
Type: Active
Recharge Time: Instant
Item Pool: Item Room, Devil Room
Guppy's Hairball
ItemID: 187
"Swing it"
Quality: 1
Follows behind Isaac and can be swung back and forth, dealing 5 contact damage per tick to anything it hits
Every time the hairball kills an enemy, it grows in size allowing it to deal more damage
This is one of the items which allows you to transform into Guppy
Moving to a new floor decreases the size of the hairball
Counts as 1 of 3 cat items needed towards the Guppy transformation
Type: Passive, Familiar
Item Pool: Devil Room
Abel
ItemID: 188
"Mirrored buddy"
Quality: 0
A familiar that mirrors the player's movements and shoots tears directly at Isaac
Abel's tears do 3.5 damage, unless playing as Cain in which case they do 5
Counts as 1 of 3 familiar items needed towards the Conjoined transformation.
Unlock this item by beating the Dark Room with Cain
Type: Passive, Familiar
Item Pool: Item Room
SMB Super Fan
ItemID: 189
"All stats up"
Quality: 3
Isaac turns red like Meatboy
+1 HP Up
+0.3 Damage Up
+0.2 Tears Up
+1.5 Range Up
+0.2 Speed Up
Full red heart heal
Unlock this item by beating Challenge #14 (It's in the Cards)
Type: Passive
Item Pool: Item Room
Pyro
ItemID: 190
"99 bombs"
Quality: 3
Gives Isaac 99 bombs
Type: Passive
Item Pool: Item Room, Secret Room, Bomb Beggar
3 Dollar Bill
ItemID: 191
"Rainbow tears"
Quality: 3
Grants Isaac random tear effects
Can pick from a list of 39 item effects, including 8 Inch Nails, 20/20, Apple!, Ball of Tar, Continuum, Cricket's Body, Dark Matter, Dead Eye, Death's Touch, Euthanasia, Explosivo, Eye of Belial, Fire Mind, Holy Light, Iron Bar, Little Horn, Lost Contact, Mom's Contacts, Mom's Eyeshadow, Mom's Perfume, Mutant Spider, My Reflection, Mysterious Liquid, Number One, Ouija Board, Parasitoid, Proptosis, Pupula Duplex, Rubber Cement, Sagittarius, Scorpio, Sinus Infection, Speed Ball, Spoon Bender, The Inner Eye, The Parasite, The Sad Onion, The Wiz and Tough Love
The tear type changes every 2-3 seconds
Type: Passive, Tear Modifier
Item Pool: Item Room
Telepathy for Dummies
ItemID: 192
"Temporary psychic shot"
Quality: 1
When used, Isaac gains homing shots and +3.0 Range Up for the current room
Counts as 1 of 3 book items needed towards the Bookworm transormation
Type: Active
Recharge Time: 2 rooms
Item Pool: Item Room, Library
MEAT!
ItemID: 193
"DMG + HP up"
Quality: 2
+1 HP Up
+0.3 Damage Up
Heals one red heart container when picked up
Type: Passive
Item Pool: Boss Room
Magic 8 Ball
ItemID: 194
"Shot speed up"
Quality: 1
+0.16 Shot Speed Up
Gives Isaac a random tarot card when picked up
+15% chance for Planetariums to spawn
Counts as 1 of 3 astrology items needed in the same run to unlock Planetariums
Type: Passive
Item Pool: Boss Room, Gold/Stone Chest
Mom's Coin Purse
ItemID: 195
"What's all this...?"
Quality: 1
Drops 4 random pills on the floor around Isaac
Counts as 1 of 3 mom items needed towards the Mom transformation
Type: Passive
Item Pool: Shop, Boss Room, Challenge Room, Beggar, Demon Beggar, Mom's Chest
Squeezy
ItemID: 196
"Tears up"
Quality: 3
+2 Soul Hearts
+0.4 Tears Up
Type: Passive
Item Pool: Boss Room, Gold/Stone Chest
Jesus Juice
ItemID: 197
"Damage + range up"
Quality: 2
+0.5 Damage Up
+0.38 Range Up
Type: Passive
Item Pool: Boss Room, Angel Room
Box
ItemID: 198
"Stuff"
Quality: 0
When picked up, spawns 1 red heart, 1 key, 1 bomb, 1 coin, 1 card/rune, 1 pill and 1 trinket
Type: Passive
Item Pool: Boss Room, Challenge Room
Mom's Key
ItemID: 199
"Better chest loot +2 keys"
Quality: 3
+2 Keys
Doubles the yield of hearts, coins, bombs and keys that spawn from non-red chests
Counts as 1 of 3 mom items needed towards the Mom transformation
Type: Passive
Item Pool: Shop, Challenge Room, Key Beggar, Mom's Chest
Mom's Eyeshadow
ItemID: 200
"Charm tears"
Quality: 1
Tears have a random chance to charm enemies
Charmed enemies will prioritize attacking other enemies in the room, otherwise they will still attack Isaac
The chance to charm enemies is affected by your luck stat and at +27 Luck it will activate every time
Counts as 1 of 3 mom items needed towards the Mom transformation
Type: Passive
Item Pool: Item Room, Challenge Room, Mom's Chest
Iron Bar
ItemID: 201
"Concussive tears"
Quality: 2
+0.3 Damage Up
Tears now have a chance to concuss enemies, causing them to walk around dazed and confused for a short period of time
The chance to concuss enemies is affected by your luck stat and at +27 Luck it will activate every time
Type: Passive
Item Pool: Item Room
Midas Touch
ItemID: 202
"Golden touch"
Quality: 2
Isaac's touch now petrifies enemies, turning them to gold for a few seconds.
If an enemy is killed while it is golden, it will drop between 1-4 coins
Contact damage is also dealt to enemies equal to the amount of coins Isaac is currently holding
Has a synergy with The Poop item, which gives it a high chance to spawn golden poops
Type: Passive
Item Pool: Item Room
Humbleing Bundle
ItemID: 203
"1+1free 4evar!"
Quality: 3
All future pennies, keys, bombs and hearts have a chance to drop in pairs
Does not work for other pickups, such as soul hearts, nickels, dimes, cards, pills etc
Does not affect existing pickups that already dropped before taking this item
Type: Passive
Item Pool: Shop
Fanny pack
ItemID: 204
"Filled with goodies"
Quality: 1
When you take damage, there is a 50% chance to drop a random heart, key, bomb or coin
Type: Passive
Item Pool: Shop, Beggar
Sharp Plug
ItemID: 205
"Charge with blood"
Quality: 2
When your spacebar item is not fully charged, you can press spacebar to recharge it at the cost half of a heart per charge
Can be used on partially charged items
Will not kill you if used - it stops a half a heart left
Red hearts are taken before other kinds, i.e. soul or black hearts
Your devil deal chance isn't ruined by this item taking away red hearts
Type: Passive
Item Pool: Shop
The Guillotine
ItemID: 206
"An out-of-body experience"
Quality: 2
+1.0 Damage Up
-1 Tear Delay (Tears Up)
Causes Isaac's head to detach and orbit his body, blocking shots and dealing 7 contact damage per tick
BFFs will cause the Guillotine head to do double damage (14 damage per tick)
Tears are still fired from Isaac's head but the hitbox remains around his body
Unlock this item by beating the Isaac boss with Judas
Type: Passive
Item Pool: Item Room
Ball of Bandages
ItemID: 207
"Gotta lick em all"
Quality: 2
Gives Isaac an orbital ball of bandages that deals 7 contact damage per tick and blocks enemy shots
Collecting a second Ball of Bandages in the run turns the orbital into a pink head that shoots tears that deal 7 damage each and have a chance to charm enemies
Getting a third Ball of Bandages will transform the head into bandage girl which will chase enemies dealing 3.5 contact damage per tick while firing charm tears
A fourth Ball of Bandages will make the Bandage Girl bigger and stronger, making her deal 5.5 damage per tick instead
Any further Ball of Bandages will repeat the cycle
Charmed enemies will prioritize attacking other enemies in the room, otherwise they will still attack Isaac
Type: Passive, Orbital
Item Pool: None (Horsemen boss only)
Champion Belt
ItemID: 208
"DMG + Challenge up"
Quality: 3
+1.0 Damage Up
Increases the chance of champion enemies appearing by 15%
Doesn't affect the chance for champion bosses to spawn
An item only found in the Shop room pool
Type: Passive
Item Pool: Shop
Butt Bombs
ItemID: 209
"Toxic blast +5 bombs"
Quality: 2
+5 bombs
Bombs now become poop bombs, which deal 10 damage to all enemies in the room and daze them for a short period of time
Butt Bombs heal the poop bosses (Dingle, Dangle, Brownie) by 25% of their max HP
Counts as 1 of 3 poop items needed towards the Oh Crap transformation.
Type: Passive
Item Pool: Item Room, Bomb Beggar
Gnawed Leaf
ItemID: 210
"Unbreakable"
Quality: 1
If Isaac stands still and stops shooting for a second, he turns to stone, making him invincible until he moves/shoots again
Using bombs or your active item will remove the invicibility as well
This item is a reference to the Tanuki suit in Super Mario 3
Type: Passive
Item Pool: Item Room
Spiderbaby
ItemID: 211
"Spider revenge"
Quality: 0
Spawns 2-5 friendly attack spiders every time you take damage
Counts as 1 of 3 spider items needed towards the Spider Baby transformation
Type: Passive
Item Pool: Item Room
Guppy's Collar
ItemID: 212
"Eternal life?"
Quality: 1
When Isaac dies, he has a 50% chance to resurrect with 1/2 a heart
Counts as 1 of 3 cat items needed towards the Guppy transformation
Type: Passive
Item Pool: Devil Room, Curse Room, Red Chest
Lost Contact
ItemID: 213
"Shielded tears"
Quality: 2
All of Isaac's tears now have a shield, allowing them to block an enemy projectile
If a tear blocks something, both Isaac's and the enemies tears are destroyed
-0.16 Shot Speed Down
Type: Passive
Item Pool: Item Room, Secret Room
Anemic
ItemID: 214
"Toxic blood"
Quality: 1
+1.5 Range Up
When Isaac takes damage, he will start to leave a trail of blood creep behind him as he walks for the current room. The creep deals 2 damage per tick while enemies stand in it
Lazarus' revived form (Lazarus II) respawns with this item
Type: Passive
Item Pool: Item Room
Goat Head
ItemID: 215
"He accepts your offering"
Quality: 3
Gives Isaac a guaranteed devil or angel room on every floor that they can appear, even if you have already beaten the boss and it didn't show up originally
Taking the Goat Head (or any other item) in a Devil Deal bars you from encountering Angel Rooms naturally. After which, the only way to access an Angel Room is via the Sacrifice Room
Type: Passive
Item Pool: Devil Room, Curse Room
Ceremonial Robes
ItemID: 216
"Sin up"
Quality: 3
+3 Black Hearts
+1 Damage Up
When depleted, Black Hearts deal 40 damage to the entire room, in a Necronomicon style effect
Type: Passive
Item Pool: Devil Room, Curse Room, Demon Beggar
Mom's Wig
ItemID: 217
"You feel itchy"
Quality: 2
Isaac now has a small chance to create friendly attack spiders everytime he fires a tear
Can create up to a maximum of 5 spiders in the room at one time
The Hive Mind item allows Mom's Wig to spawn a maximum of 10 spiders at once, and increases their damage
The chance to create a spider is affected by your luck stat and at +10 Luck it will activate every time
Heals you for 1 red heart when picked up
Counts as 1 of 3 mom items needed towards the Mom transformation
Type: Passive
Item Pool: Item Room, Challenge Room, Mom's Chest
Placenta
ItemID: 218
"HP up + regen"
Quality: 2
+1 HP Up
Gives a chance to heal 1/2 a red heart every time the in-game timer hits a new minute
Heals one red heart container when picked up
There are no restrictions on when the regeneration effect happens as long as the game is not paused, so you can simply afk and heal over time
Works in crawl spaces
It's possible to find this item by blowing up Polyps (the weird red rocks found in the Womb floors)
Type: Passive
Item Pool: Boss Room
Old Bandage
ItemID: 219
"HP up"
Quality: 2
+1 HP Up
The given heart container is empty
When you get hit, you will sometimes cause hearts to drop on the floor
The chance to drop hearts is affected by your luck stat and at +29 Luck it will activate 50% of the time
Type: Passive
Item Pool: Boss Room
Sad Bombs
ItemID: 220
"Tear blast +5 bombs"
Quality: 2
+5 Bombs
Everytime a bomb explodes, it will release a circle of 10 tears outwards, much like the Tammy's Head effect
The tears from each bomb deal a flat 25 damage and are affected by any tear modifiers Isaac has
The tears caused by Sad Bombs are much larger and do a lot more damage than Isaac's normal tears
Type: Passive
Item Pool: Item Room, Bomb Beggar
Rubber Cement
ItemID: 221
"Bouncing tears"
Quality: 3
Isaac's tears now bounce off walls and objects in the environment, such as rocks and pots
Allows tears to hit the same enemy multiple times
If you also have Lost Contact, tears will bounce off enemy projectiles instead of being destroyed
Unlock this item by beating Mom's heart 2 times
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Anti-Gravity
ItemID: 222
"Antigravity tears + tears up"
Quality: 2
-2 Tear Delay (Tears Up)
As you hold down the fire button, shots will float in the same place until you release the fire key again
Allows you to store up a lot of tears in the air and release them all at once
When the tears are released, they will fire off in the direction that Isaac was originally facing when it was created
Type: Passive, Tear Modifier
Item Pool: Item Room
Pyromaniac
ItemID: 223
"Hurts so good +5 bombs"
Quality: 3
+5 Bombs
All explosions now heal Isaac for 0.5 red hearts instead of hurting him
Pyromaniac grants Isaac immunity to fire, but does not protect against stomps or shockwave effects
Type: Passive
Item Pool: Item Room
Cricket's Body
ItemID: 224
"Splash damage + tears up"
Quality: 3
-1 Tear Delay (Tears Up)
-1.3 Range Down
x1.2 Tear Size
Makes tears break into 4 smaller tears on impact with anything, which deal half of your damage
Type: Passive
Item Pool: Item Room
Gimpy
ItemID: 225
"Sweet suffering"
Quality: 2
When getting hit, this item has a chance to drop a soul heart or black heart
The chance to spawn a heart is affected by your luck stat and at +22 Luck it will activate 50% of the time
Enemies have a chance to drop half a red heart when killed
Type: Passive
Item Pool: Item Room, Devil Room, Curse Room, Demon Beggar
Black Lotus
ItemID: 226
"HP up x3"
Quality: 2
+1 HP Up
+1 Soul Heart
+1 Black Heart
Heals one red heart container when picked up
When depleted, Black Hearts deal 40 damage to the entire room, in a Necronomicon style effect
An item only found in the secret room pool
Type: Passive
Item Pool: Secret Room
Piggy Bank
ItemID: 227
"My life savings"
Quality: 1
+3 Coins when picked up
When you take damage, 1-2 coins will drop on the floor
When playing as the Keeper, this item drops 0-1 coins instead
Type: Passive
Item Pool: Item Room, Shop
Mom's Perfume
ItemID: 228
"Fear shot"
Quality: 2
-1 Tear Delay (Tears Up)
Isaac's tears have a 15% chance of causing a fear effect
Feared enemies will run away from Isaac temporarily
The chance to fear enemies is affected by your luck stat and at +85 Luck it will activate every time
Counts as 1 of 3 mom items needed towards the Mom transformation
Type: Passive
Item Pool: Item Room, Challenge Room, Mom's Chest
Monstro's Lung
ItemID: 229
"Charged attack"
Quality: 2
Tears can now be charged and released in a shotgun style effect, much like Monstro's main attack
Tears down (Tear delay * 4.3)
Partial charging does nothing - must be fully charged to use
Type: Passive, Tear Modifier
Item Pool: Item Room
Abaddon
ItemID: 230
"Evil up + DMG up + fear shot"
Quality: 3
On pickup Abaddon converts all your heart containers to black hearts, then gives you +2 more black hearts
+1.5 Damage Up
+0.2 Speed Up
Tears now have a chance to induce the fear effect, causing enemies to run away from Isaac for a short period
The chance to fear enemies is affected by your luck stat and at +85 Luck it will activate every time
When depleted, Black Hearts deal 40 damage to the entire room, in a Necronomicon style effect
Counts as 1 of 3 evil items needed towards the Leviathan transformation
When taken as The Keeper, your coin health is reduced to 1
Unlock this item by beating the Chest with Azazel
Type: Passive
Item Pool: Devil Room, Demon Beggar
Ball of Tar
ItemID: 231
"Sticky feet..."
Quality: 2
Isaac leaves a trail of tar behind him which will slow down enemies that walk over it
Tears have a chance to slow enemies and their projectiles for a short period of time
The chance to slow enemies can improve based on your luck stat and will always slow enemies at +18 Luck
Type: Passive
Item Pool: Item Room
Stop Watch
ItemID: 232
"Let's slow this down a bit"
Quality: 4
+0.3 Speed Up
The Stop Watch applies a permanent but slight slowing effect to all enemies and their projectiles
The slowing effect has a reduced effect against Brimstone lasers fired by enemies
Unlock this item by donating 999 pennies to the Shop
Type: Passive
Item Pool: Shop
Tiny Planet
ItemID: 233
"Orbiting tears + range up"
Quality: 0
Range greatly increased
Grants spectral tears
Tears now revolve around Isaac's Body at a fixed distance until they hit the ground
The tears orbit close to Isaac, offset slightly in the direction fired. Changing the firing direction will redirect all previously fired tears
Causes a lot of great synergies with items such as Lump of Coal, Brimstone, Rubber Cement, Technology and most of the worm trinkets
Type: Passive, Tear Modifier
Item Pool: Item Room
Infestation 2
ItemID: 234
"Infestation shot"
Quality: 3
Creates a friendly blue spider when you kill an enemy
Spiders are spawned at the location where the enemy died
Counts as 1 of 3 spider items needed towards the Spider Baby transformation.
Type: Passive
Item Pool: Item Room
E. Coli
ItemID: 236
"Turdy Touch"
Quality: 1
E. Coli turns normal enemies into poop if they touch you
Enemies can turn into poop even if they do not do contact damage, allowing you to apply the effect without taking damage
Can be combined with Midas Touch to turn enemies into Golden Poop
This does not work on mini-bosses and bosses
Counts as 1 of 3 poop items needed towards the Oh Crap transformation
Type: Passive
Item Pool: Item Room
Death's Touch
ItemID: 237
"Penetrative shots + DMG up"
Quality: 3
+1.5 Damage Up
-0.3 Tears Down
x2 Tear Size
Isaac's tears turn into large scythes that pierce through enemies (Similar to how Death's scythes look)
Unlock this item by beating Challenge #17 (Waka Waka)
Type: Passive, Tear Modifier
Item Pool: Item Room, Devil Room
Key Piece #1
ItemID: 238
"???"
Quality: 0
Increases your chances to find an Angel Room instead of a Devil Room. See the dedicated Devil room page for more details
First half of the key required to enter the door to the Mega Satan boss
Drops from one of the angels which appear by bombing the statue in an angel room
Type: Passive, Familiar
Item Pool: None (Angel statue only)
Key Piece #2
ItemID: 239
"???"
Quality: 0
Increases your chances to find an Angel Room instead of a Devil Room. See the dedicated Devil room page for more details
Second half of the key required to enter the door to the Mega Satan boss
Drops from one of the angels which appear by bombing the statue in an angel room
Type: Passive, Familiar
Item Pool: None (Angel statue only)
Experimental Treatment
ItemID: 240
"Some stats up, some stats down"
Quality: 1
Randomly increases 4 of your stats, and decreases 2 of them
Possible stat changes are fixed values: Ā±1 health, Ā±1 damage, Ā±0.2 speed, Ā±0.5 range, Ā±0.5 tears, Ā±0.2 shot speed, Ā±1 luck
Counts as 1 of 3 syringe items needed towards the Spun transformation
Unlock this item by beating Mom's Heart 7 times
Type: Passive
Item Pool: Item Room, Boss Room, Demon Beggar
Contract From Below
ItemID: 241
"Wealth, but at what cost?"
Quality: 3
Doubles pickups and chests from clearing a room
Also gives a 30% chance for room clear rewards to not spawn
Doesn't affect coins spawned in Greed Mode
Type: Passive
Item Pool: Devil Room, Curse Room, Demon Beggar
Infamy
ItemID: 242
"Damage reduction"
Quality: 2
Gives a 50% chance to not take damage from projectiles
Type: Passive
Item Pool: Item Room, Secret Room
Trinity Shield
ItemID: 243
"You feel guarded"
Quality: 2
Puts a shield in front of Isaac which blocks projectiles
The shield will rotate based on the direction in which Isaac is firing tears
Type: Passive
Item Pool: Angel Room
Tech.5
ItemID: 244
"It's still being tested"
Quality: 3
Gives Isaac a laser that will fire at random intervals in addition to your normal tears
Each laser does damage equal to your current tear damage
The laser will occasionally fire with one of these effects: Hook Worm, Spoon Bender, Tiny Planet, Mysterious Liquid, Rubber Cement
Luck has no effect on the rate at which Tech.5 fires and does not scale with items that increase your tears stat
Unlock this item by beating Challenge #18 (The Host)
Type: Passive, Tear Modifier
Item Pool: Item Room
20/20
ItemID: 245
"Double shot"
Quality: 4
Isaac now shoots two tears at once
0.75x damage multiplier
Unlike the Inner Eye and Mutant Spider items, this double shot item does not give a tears down
Type: Passive, Tear Modifier
Item Pool: Item Room
Blue Map
ItemID: 246
"Secrets"
Quality: 2
Reveals the locations of the secret and super secret room for the current floor and all future floors
Unlock this item by donating 10 pennies to the Shop
Type: Passive
Item Pool: Shop, Beggar, Key Beggar
BFFS!
ItemID: 247
"Your friends rule!"
Quality: 2
Makes all of Isaac's familiars stronger and bigger
Causes most familiars to deal double damage
Has no effect on most familiars that scale with Isaac's tear damage
Type: Passive
Item Pool: Shop, Key Beggar
Hive Mind
ItemID: 248
"Giant spiders and flies"
Quality: 2
Causes your friendly blue spiders and flies to become bigger and do x2 more damage
Allows Mom's Wig to spawn a maximum of 10 spiders at once instead of 5
Fly and spider familiars become stronger similar to BFFS
Counts as 1 of 3 fly items needed towards the Beelzebub transformation
Counts as 1 of 3 spider items needed towards the Spider Baby transformation.
Type: Passive
Item Pool: Shop
There's Options
ItemID: 249
"More options"
Quality: 3
Two items now spawn after beating a boss fight and the boss rush, however only one can be taken
The additional item will pick from the Boss Item Pool
Does nothing after the Krampus fight
Unlocked by donating to the donation machine in the shop
Unlock this item by donating 50 pennies to the Shop
Type: Passive
Item Pool: Shop
Bogo Bombs
ItemID: 250
"1+1 bombs"
Quality: 1
All bomb pickups are now 1+1 bombs
An item only found in the Shop item pool
Type: Passive
Item Pool: Shop
Starter Deck
ItemID: 251
"Extra card room"
Quality: 2
Spawns a random card
Isaac can now hold 2 cards or runes at once. Tap the drop button to cycle between each one
All future pill drops will now instead become cards
An item only available in the Shop room
Type: Passive
Item Pool: Shop
Little Baggy
ItemID: 252
"Extra pill room"
Quality: 0
Allows for 2 pills to be held. Tap the drop button to cycle between each one
Drops a pill on the floor when picked up
Changes all card and rune drops into pills. Any Tarot card or rune on the floor or current held when picking this item up will change into a pill
Dice Shard counts as a card and will be converted
Unlock this item by picking up 2 of the following items: Roid Rage, The Virus, Growth Hormones, Experimental Treatment or Speed Ball
Type: Passive
Item Pool: Shop
Magic Scab
ItemID: 253
"HP + luck up"
Quality: 2
+1 HP Up
+1.0 Luck Up
Heals one red heart container when picked up
Type: Passive
Item Pool: Boss Room
Blood Clot
ItemID: 254
"DMG + range up"
Quality: 2
+1.0 Damage Up (Left eye only)
+1.5 Range Up (Left eye only)
The above stats only apply to tears fired from Isaac's left eye or with a 50% chance if you have an item which causes you to fire from a single source only
Type: Passive
Item Pool: Boss Room
Screw
ItemID: 255
"Tears + shot speed up"
Quality: 3
+0.5 Tears Up
+0.2 Shot Speed Up
Type: Passive
Item Pool: Boss Room, Gold/Stone Chest
Hot Bombs
ItemID: 256
"Burning blast +5 bombs"
Quality: 1
+5 Bombs
Grants immunity to fire
Enemies touching placed bombs take 16 damage
Gives all bombs a burning effect when they explode, leaving fire on the floor which deals 22 damage to enemies
Type: Passive
Item Pool: Item Room, Bomb Beggar
Fire Mind
ItemID: 257
"Flaming tears"
Quality: 2
Isaac's tears now set enemies on fire, leaving a damage over time effect that does 4 or 6 damage per tick
There is a chance that tears that hit enemies will explode, leaving a small fire on the floor that damages enemies
Exploding tears deal damage * 2 + 22 per tick
The chance for tears to explode is affected by your luck stat and at +13 Luck it will activate every time
Type: Passive
Item Pool: Item Room
Missing No
ItemID: 258
"Syntax error"
Quality: 0
When picked up, and at the start of each floor this rerolls all your current items, giving you a new item to replace each of the ones you had
Also rerolls all your stats at the same time, giving a random flat modifier that changes each time
Doesn't affect important items such as Polaroid, Negative and Key Pieces
Unlock this item by beating Boss Rush with Lazarus
Type: Passive
Item Pool: Secret Room
Dark Matter
ItemID: 259
"Fear shot"
Quality: 3
+1.0 Damage Up
Tears now have a chance to apply the fear effect to enemies, which causes them to run away from Isaac
The chance to fear enemies is affected by your luck stat and at +20 Luck it will activate every time
An item only found in the devil room pool (Note: The Fallen boss pulls items from the Devil Room Pool)
Type: Passive
Item Pool: Devil Room, Demon Beggar
Black Candle
ItemID: 260
"Curse of immunity + evil up"
Quality: 3
+1 Black Heart
Immunity to all floor curses (e.g. Curse of the Lost)
Black Candle removes the teleportation effect of Cursed Eye
+15% chance of a devil or angel room opening after the boss fight
Unlock this item by donating 150 pennies to the Shop
Type: Passive
Item Pool: Shop, Curse Room
Proptosis
ItemID: 261
"Short range mega tears"
Quality: 3
Gives Isaac high damage tears with a short range
Tear size and damage falls off very fast with this item, the further the tear travels the less damage it does
Tear damage starts at triple (300%) and decreases over range to eventually be 0%
Type: Passive, Tear Modifier
Item Pool: Item Room
Missing Page 2
ItemID: 262
"Evil up + your enemies will pay"
Quality: 0
+1 Black Heart
If the total sum of all your health is at one heart after taking damage, the necronomicon effect will activate, dealing 40 damage to the entire room
Missing Page 2 now doubles all black heart and Necronomicon damage to 80
Type: Passive
Item Pool: Devil Room, Demon Beggar, Secret Room
Smart Fly
ItemID: 264
"Revenge fly"
Quality: 2
A yellow orbital fly that will block shots and when Isaac gets hit, will seek out the nearest enemy and attack it
If the fly is in its attacking state and there are no longer any enemies in range, it will return to Isaac and go back to being a defensive orbital
Counts as 1 of 3 fly items needed towards the Beelzebub transformation
Type: Passive, Familiar
Item Pool: Item Room, Key Beggar
Dry Baby
ItemID: 265
"Immortal friend"
Quality: 3
A familiar that follows Isaac and blocks any shots that hit it
If a projectile is blocked by Dry Baby, he has a 10% chance to activate the Necronomicon effect, dealing 40 damage to the entire room
The chance to activate the effect is not changed by your Luck stat
Can drop while destroying skulls in the Depths and Necropolis floors
Counts as 1 of 3 familiar items needed towards the Conjoined transformation.
Type: Passive, Familiar
Item Pool: Item Room
Juicy Sack
ItemID: 266
"Sticky babies"
Quality: 2
A familiar that follows isaac around dropping white creep which slows down enemies that walk over it
Spawns 1-2 familiar blue spiders after every room
Blue Spiders do x2 of Isaac's damage
Counts as 1 of 3 spider items needed towards the Spider Baby transformation.
Type: Passive, Familiar
Item Pool: Item Room
Robo-Baby 2.0
ItemID: 267
"We worked out all the kinks"
Quality: 1
A familiar that is controlled via the arrow keys and will automatically fire a laser if anything is in its line of sight
Robo-Baby 2.0's lasers deal 3.5 damage per hit
Counts as 1 of 3 familiar items needed towards the Conjoined transformation.
Unlock this item by beating Challenge #16 (Computer Savvy)
Type: Passive, Familiar
Item Pool: Item Room
Rotten Baby
ItemID: 268
"Infested friend"
Quality: 3
A familiar which follows Isaac and spawns a blue flies as you're firing tears
Rotten Baby can only create one fly at a time, meaning if he has created a fly he cannot make another until it is used
Blue Flies do double your tear damage
Counts as 1 of 3 familiar items needed towards the Conjoined transformation
Type: Passive, Familiar
Item Pool: Item Room, Devil Room
Headless Baby
ItemID: 269
"Bloody friend"
Quality: 1
A familiar that follows Isaac and leaves blood creep on the floor as it floats, hurting enemies that walk over it for 2 damage per tick
Counts as 1 of 3 familiar items needed towards the Conjoined transformation
Type: Passive, Familiar
Item Pool: Item Room, Devil Room
Leech
ItemID: 270
"Blood sucker"
Quality: 2
Spawns a familiar leech on the ground that hunts down enemies and heals you for half a heart each time it eats one
The Leech deals 1.5 contact damage per tick
Type: Passive, Familiar
Item Pool: Item Room
Mystery Sack
ItemID: 271
"?"
Quality: 2
A bag that follows Isaac and drops a random heart, coin, bomb or key every 5-6 rooms (alternating, 5 rooms then 6, then repeats)
Can drop any kind of heart, coin, bomb or key
Unlock this item by beating the Dark Room with Eden
Type: Passive, Familiar
Item Pool: Item Room, Beggar, Secret Room
BBF
ItemID: 272
"Big beautiful fly"
Quality: 1
A large familiar black fly that bounces around the room, exploding on contact with enemies dealing 70 damage
Does not explode if it hits Isaac, however if it explodes on an enemy while Isaac is in range, he will take damage
Respawns after 10 seconds or by moving to another room
Picking up this item as well as 2 other fly-type items will allow you to transform into Lord of the Flies
Counts as 1 of 3 fly items needed towards the Beelzebub transformation
Type: Passive, Familiar
Item Pool: Item Room
Bob's Brain
ItemID: 273
"Explosive thoughts"
Quality: 1
A green brain that launches in the direction you are firing your tears and will explode on contact with enemies, dealing damage and poisoning anything in the blast radius
Bob's Brain deals 100 damage and applies a poison damage over time effect, which deals double your tear damage per tick
Regenerates over time
Will hurt Isaac if he is in the blast radius
Counts as 1 of 3 poison items needed towards the Bob transformation
Type: Passive, Familiar
Item Pool: Item Room, Rotten Beggar
Best Bud
ItemID: 274
"Sworn protector"
Quality: 0
When Isaac takes damage, a white attack fly will spawn that orbits him at a similar distance to the Distant Admiration fly
The fly orbits a lot faster than Distant Admiration or Forever Alone and deals 10 damage per tick
Picking up this item as well as 2 other fly-type items will allow you to transform into Lord of the Flies
Counts as 1 of 3 fly items needed towards the Beelzebub transformation
Type: Passive, Orbital
Item Pool: Item Room, Key Beggar
Lil Brimstone
ItemID: 275
"Evil friend"
Quality: 2
A familiar that follows Isaac and can fire up and charge brimstone shots, exactly how the normal Brimstone item works but with less damage
Each laser deals 3 damage per tick, up to 8 times for a total of 24 damage
A familiar found in the devil room
Lil Brimstone is now unable to start charging until he is finished attacking
Counts as 1 of 3 familiar items needed towards the Conjoined transformation.
Type: Passive, Familiar
Item Pool: Item Room, Devil Room
Isaac's Heart
ItemID: 276
"Protect it"
Quality: 0
Prevents Isaac from taking any damage, but instead summons a familiar heart that follows you around. If the heart is hit, Isaac will take damage
It will attempt to hide behind you when shooting
Most enemies will target the heart over Isaac himself
Isaac's Heart has a charge attack, which when released will push enemies away and fire blood tears in all directions
Spikes, Curse Rooms and Spiked Chests no longer deal damage to you, but sacrifice rooms still work as normal
Sharp Plug becomes useless with this item, due to how damage is prevented on Isaac's body
Unlock this item by beating the Isaac boss with The Lost
Type: Passive, Familiar
Item Pool: Item Room
Lil Haunt
ItemID: 277
"Fear him"
Quality: 1
A familiar ghost that follows Isaac around and chases enemies close-by, damaging them for 2 contact damage and causing a fear effect
Type: Passive, Familiar
Item Pool: Item Room
Dark Bum
ItemID: 278
"He wants to take your life"
Quality: 3
A familiar beggar similar to Bum Friend that follows Isaac and collects red hearts, giving Isaac black hearts, pills, cards, runes or spiders in return
For every 1.5 red hearts he takes, he will give a reward
Reward chances: Black Heart - 40%, Card/Rune - 20%, Pill - 20%, Blue Spider - 10%, Spider 10%
Counts as 1 of 3 bum items needed towards the Super Bum transformation
Type: Passive, Familiar
Item Pool: Item Room, Devil Room, Demon Beggar
Big Fan
ItemID: 279
"Fat protector"
Quality: 2
A very large orbital that moves around Isaac very slowly, blocking shots and dealing 2 contact damage per tick
Affects the speed of all other orbitals, slowing them down a lot (NOTE: This effect does not happen until you get a new orbital after Big Fan)
Does not count as one of your three standard orbital slots
Counts as 1 of 3 fly items needed towards the Beelzebub transformation
Type: Passive, Orbital
Item Pool: Item Room
Sissy Long Legs
ItemID: 280
"She loves you"
Quality: 1
An adorable friendly blue spider that walks around the room laying other blue spiders which attack enemies
Blue Spiders do x2 of Isaac's damage
She can only spawn a maximum of up to 5 spiders at a time and will only do so while there are enemies in the room
Sissy Long Legs also charms enemies on contact
Counts as 1 of 3 spider items needed towards the Spider Baby transformation.
Type: Passive, Familiar
Item Pool: Item Room
Punching Bag
ItemID: 281
"Scape goat"
Quality: 1
Spawns a friendly Mulligan that walks around the room. Mulligan can be hit by enemy projectiles, making him a good shield
Enemies will sometimes target the Mulligan if he is closer
Type: Passive, Familiar
Item Pool: Item Room
How To Jump
ItemID: 282
"It's time you learned how"
Quality: 1
When used, makes Isaac leap in the air, similar to the leaper enemies
Maintains momentum if you are already moving in the same direction
If you already have an item which gives you flying, this item becomes a dash effect instead
Can be used in the Isaac boss fight to jump over the beams of light he spawns
Type: Active
Recharge Time: Instant
Item Pool: Item Room, Library
D100
ItemID: 283
"REEROLLLLL!"
Quality: 3
When used, the D100 will activate the effects of all other dice items at once, including D1, D4, The D6, D7, D8, D10, D12 and D20. Search 'Dice effect' to see all those items and their relevant effects
Note: Full run reroll effects (such as D4) are able to remove heart containers and transformations if losing the respective items during the reroll
Unlock this item by beating Boss Rush with The Lost
Type: Active
Recharge Time: 6 rooms
Item Pool: Item Room
D4
ItemID: 284
"Reroll into something else"
Quality: 2
When used, the D4 re-rolls each item you currently have into another random item from the same item pool
If you have an item with no room pool (e.g. Blood Bag) it will be rerolled into a random Item Room item
Full run reroll effects such as D4 are able to remove heart containers and transformations if losing the respective items during the reroll
Cannot remove Azazel's Brimstone laser, or The Lost's Holy Mantle
Unlock this item by blowing up 30 slot machines
Type: Active
Recharge Time: 6 rooms
Item Pool: Item Room
D10
ItemID: 285
"Rerolls enemies"
Quality: 1
When used, rerolls all enemies in the room which are currently alive into another random type of enemy
D10 attempts to reroll enemies into enemies of similar health where possible
Cannot reroll mini-bosses or bosses
Type: Active
Recharge Time: 2 rooms
Item Pool: Item Room
Blank Card
ItemID: 286
"Card Mimic"
Quality: 2
When used, copies the effect of the card you are currently holding without consuming it
The charge time depends on the quality of the card you're holding, and will update with each activation
Using this with the ? card will teleport you to the I AM ERROR room
Unlock this item by beating the Isaac boss with Eden
Type: Active
Recharge Time: Varies
Item Pool: Shop, Secret Room
Book of Secrets
ItemID: 287
"??????"
Quality: 1
When used, you have a chance of getting one of the three following effects: Treasure Map (floor layout), Compass (map icons) or Blue Map (secret room locations)
Counts as 1 of 3 book items needed towards the Bookworm transformation
Book of Secrets avoids giving mapping effects that you already have. If the player has all mapping effects, it grants the 'I can see forever!' effect for the floor
Unlock this item by beating Satan with Eden
Type: Active
Recharge Time: 6 rooms
Item Pool: Item Room, Library, Secret Room
Box of Spiders
ItemID: 288
"It's a box of spiders"
Quality: 1
When used, spawns 4-8 friendly blue spiders on the floor
Blue Spiders do x2 of Isaac's damage
Counts as 1 of 3 spider items needed towards the Spider Baby transformation
Type: Active
Recharge Time: 2 rooms
Item Pool: Item Room
Red Candle
ItemID: 289
"Flame on"
Quality: 2
When used, the candle is raised above Isaac's head. Upon pressing any fire button, a red flame will slide across the floor in that direction, dealing 23 damage per tick to enemies that come into contact with it
Each flame deals 125 total damage and disappears after 10 seconds
The flame will shrink in size when deals damage to something and eventually disappear
Unlock this item by donating 400 pennies to the Shop
Type: Active
Recharge Time: Timed (A few seconds)
Item Pool: Shop
The Jar
ItemID: 290
"Save your life"
Quality: 0
Isaac can now pick up hearts while at full health, which will be stored in the Jar and can be spawned again using the spacebar
Up to 4 hearts can be stored in The Jar
Soul hearts and black hearts cannot be stored
If used in a Black heart or Eternal heart super secret room, it will spawn the relevant heart
Type: Active
Recharge Time: Instant
Item Pool: Shop
FLUSH!
ItemID: 291
"..."
Quality: 1
When used, turns every normal enemy in the room into poop!
Does not work on mini-bosses and bosses
Kills poop bosses when used - Dingle, Dangle and Brownie
Counts as 1 of 3 poop items needed towards the Oh Crap transformation
Type: Active
Recharge Time: 4 rooms
Item Pool: Item Room
Satanic Bible
ItemID: 292
"Reusable evil... but at what cost?"
Quality: 4
When used, gives Isaac +1 Black Heart
Using this book once before the boss dies, causes the boss item on the current floor to become a devil deal instead, where it will cost heart containers to pick up. Taking this item DOES count as a devil deal, preventing future angel rooms.
When depleted, Black Hearts deal 40 damage to the entire room, in a Necronomicon style effect
Counts as 1 of 3 book items needed towards the Bookworm transformation
Unlock this item by beating the Isaac boss with Azazel
Type: Active
Recharge Time: 6 rooms
Item Pool: Item Room, Library, Devil Room
Head of Krampus
ItemID: 293
"Krampus rage"
Quality: 2
When used, fires a 4 way brimstone laser in all cardinal directions, dealing a lot of damage to any enemies
Laser damage does not scale with your damage stat - its a fixed 10 damage per tick for 20 ticks (200 total per use)
Has a chance to drop after you beat Krampus
If you get close enough to an enemy that has a large hitbox, you can hit it with 2 of the laser beams, allowing you to deal more damage
Unlock this item by beating Krampus (Krampus is unlocked by taking 20 devil deal items)
Type: Active
Recharge Time: 3 rooms
Item Pool: None (Krampus only)
Butter Bean
ItemID: 294
"Reusable knockback"
Quality: 1
When used, farts on nearby enemies and knocks them backwards forcefully away from Isaac
Allows you to reflect projectiles away from Isaac
If a pushed enemy hits a rock or wall forcefully enough, they take 10 damage
Unlock this item by destroying 100 poops
Type: Active
Recharge Time: Timed (A few seconds)
Item Pool: Item Room, Beggar
Magic Fingers
ItemID: 295
"Pay to play"
Quality: 1
Upon use, consumes a coin and deals damage to everything in the room
Damage dealt is equal to your tear damage * 2 + 10
Type: Active
Recharge Time: Instant
Item Pool: Item Room, Shop
Converter
ItemID: 296
"Convert your soul"
Quality: 2
When used, converts 1 soul/black heart into 1 red heart container
This item will take from your soul hearts first
Type: Active
Recharge Time: 3 rooms
Item Pool: Shop
Pandora's Box
ItemID: 297
"? ?"
Quality: 2
When used, this item will spawn a set of items or consumables based on which chapter you are currently on
Basement 1: 2 Soul hearts. Basement 2: 2 Bombs + 2 Keys
Caves 1: 1 Boss Item. Caves 2: 1 Boss Item + 2 Soul Hearts
Depths 1: 4 Soul hearts. Depths 2: 20 coins
Womb 1: 2 Boss Items. Womb 2: Bible
Blue Womb: Nothing!. The Void: Nothing!
Sheol: 1 Devil Room Item + 1 Black Heart. Cathedral: 1 Angel Room Item + 1 Eternal Heart
Chest: 1 coin. Dark Room: Nothing!
Home: Gives Red Key.
Pandora's Box considers XL floors to always be the first floor of a chapter
Alternative floors drop the same stuff e.g. Corpse II drops same as Womb II
Unlock this item by beating the Dark Room with Lazarus
Type: Active
Recharge Time: One time use
Item Pool: Shop, Red Chest
Unicorn Stump
ItemID: 298
"You feel stumped"
Quality: 1
When used, turns Isaac invincible and gains +0.28 speed for a 5 seconds
You cannot fire tears while the stump is active
Very similar to the My Little Unicorn item but does not deal contact damage
When used with Mom's Knife, you can still deal contact damage but will be unable to change the way the knife faces while the effect is active
Type: Active
Recharge Time: 1 room
Item Pool: Item Room
Taurus
ItemID: 299
"Speed down + rage is building"
Quality: 1
-0.3 Speed Down
While in a hostile room your speed raises at a rate of +0.065 per game tick
When you hit a speed stat of 2.0, Isaac will gain an invincibility effect for 5 seconds, increasing speed and allowing him to run into enemies to deal 40 contact damage per hit
The time it takes for the effect to activate becomes shorter with a higher base Speed stat
Counts as 1 of 3 astrology items needed in the same run to unlock Planetariums
Type: Passive
Item Pool: Item Room
Aries
ItemID: 300
"Ramming speed"
Quality: 2
+0.25 Speed up
Running into enemies while at a high speed will deal 25 damage. Moving at this speed also prevents contact damage
Will not deal contact damage unless you are moving fast enough (at least 0.85 speed)
Counts as 1 of 3 astrology items needed in the same run to unlock Planetariums
Type: Passive
Item Pool: Item Room
Cancer
ItemID: 301
"HP up + you feel protected"
Quality: 3
+3 Soul Hearts
After getting hit once, you gain a damage reduction for the rest of the room similar to The Wafer item (-50% damage taken)
Counts as 1 of 3 astrology items needed in the same run to unlock Planetariums
Type: Passive
Item Pool: Item Room
Leo
ItemID: 302
"Stompy"
Quality: 1
Isaac increases in size, gets a lion's mane and now has the ability to crush rocks by walking over them
Crushed rocks and poop can fill holes if you walk in their direction
Allows you to crush Red Poops and sometimes not take damage. However, If you also have flying you will always take damage
Counts as 1 of 3 astrology items needed in the same run to unlock Planetariums
Counts as 1 of 3 size-increasing items needed towards the Stompy transformation
Type: Passive
Item Pool: Item Room
Virgo
ItemID: 303
"You feel refreshed and protected"
Quality: 2
A random chance when you take damage to get an invincibility shield for 7 seconds
The chance to get an invincibility shield is affected by your luck stat and at +10 Luck it will activate every time you get hit
Converts all negative pills into their positive counterparts e.g. Stat Down becomes Stat Up, 'Bad Trip' turns into 'Balls of Steel' and 'Amnesia' turns into 'I can see forever'
Counts as 1 of 3 astrology items needed in the same run to unlock Planetariums
Type: Passive
Item Pool: Item Room
Libra
ItemID: 304
"You feel balanced"
Quality: 1
Gives you 6 keys, 6 bombs and 6 coins
Balances out your main stats to bring the high and low stats closer to an average value
All future stat upgrading items will now instead spread out across all other stats. For example, an item which usually gives +1 Damage would instead give a small 'all stats up'
Stats effected by this item are: Damage, Tears, Range, Speed
When taken with another item which gives an extreme value in a certain stat (e.g. Soy Milk) can lead to interesting synergies
Counts as 1 of 3 astrology items needed in the same run to unlock Planetariums
Type: Passive
Item Pool: Item Room
Scorpio
ItemID: 305
"Poison tears"
Quality: 3
Isaac's tears turn bright green and always apply a poison effect to enemies which deals a total of double your tear damage
This is essentially a superior version of The Common Cold item
Counts as 1 of 3 astrology items needed in the same run to unlock Planetariums
Type: Passive
Item Pool: Item Room
Sagittarius
ItemID: 306
"Penetrative shot + speed up"
Quality: 3
+0.2 Speed Up
Grants piercing tears
Tears do not travel through rocks with this item
Counts as 1 of 3 astrology items needed in the same run to unlock Planetariums
Type: Passive
Item Pool: Item Room
Capricorn
ItemID: 307
"All stats up"
Quality: 3
+1 HP Up
+0.5 Damage Up
-1 Tear Delay (Tears Up)
+0.1 Speed Up
+0.75 Range Up
+1 Key, +1 Bomb, +1 Coin
Heals one red heart container when picked up
Counts as 1 of 3 astrology items needed in the same run to unlock Planetariums
Type: Passive
Item Pool: Item Room
Aquarius
ItemID: 308
"A trail of tears"
Quality: 2
Leaves a trail of tears on the floor behind Isaac which damages enemies that walk over it for 2 damage per tick
Counts as 1 of 3 astrology items needed in the same run to unlock Planetariums
Aquarius synergizes with tear effects
Type: Passive
Item Pool: Item Room
Pisces
ItemID: 309
"Tears up + knockback shot"
Quality: 2
-1 Tear Delay (Tears Up)
x1.25 Tear Size Up
Tears now have a bigger knockback effect, which pushes enemies backwards
Counts as 1 of 3 astrology items needed in the same run to unlock Planetariums
Type: Passive
Item Pool: Item Room
Eve's Mascara
ItemID: 310
"Shot speed down + DMG up"
Quality: 3
x2 Damage Multiplier
Tears Down by exactly half (Tear delay * 2)
-0.5 Shot Speed Down
The tears down from this item is a x2.0 multiplier after the formula, meaning it will always halve your tear rate (Unless you have Monstro's Lung or Soy Milk)
Unlock this item by beating Boss Rush with Eve
Type: Passive
Item Pool: Item Room
Judas' Shadow
ItemID: 311
"Sweet revenge"
Quality: 3
When you die with this item, you respawn in the previous room as Dark Judas with 2 black hearts for health
Dark Judas has a damage multiplier of 2.00 (double Isaac's damage) and an additional +0.1 Speed
Dark Judas is considered a separate character by the game, however he can be used to unlock Judas' secrets/achievements
Dark Judas cannot gain red heart containers, HP upgrades give soul hearts instead
Unlock this item by beating Boss Rush with Judas
Type: Passive
Item Pool: Devil Room
Maggy's Bow
ItemID: 312
"HP up + you feel healthy"
Quality: 2
+1 HP Up
Heals one red heart container when picked up
All future red hearts now heal for double. Half hearts heal a whole heart and full hearts heal 2 red hearts
Unlock this item by beating Boss Rush with Maggy
Type: Passive
Item Pool: Item Room
Holy Mantle
ItemID: 313
"Holy shield"
Quality: 4
Each time you enter a new room, damage is negated for the first time you get hit
Can be used to go in and out of a Curse Room without taking damage
Counts as 1 of 3 angel items needed towards the Seraphim transformation
The Lost starts with this item after donating 879 coins to the Greed Donation Machine.
REPENTANCE - The Lost's Holy Mantle can no longer be re-rolled using an item like D4.
Type: Passive
Item Pool: Item Room, Angel Room
Thunder Thighs
ItemID: 314
"HP + speed down + you feel strong"
Quality: 1
+1 HP Up
-0.4 Speed Down
You can now break obstacles by walking over them
Heals one red heart container when picked up
Holes in the ground can be filled by crushing adjacent rocks, similar to how this can be done with bombs
Allows you to crush Red Poops and sometimes not take damage. However, If you also have flying you will always take damage
Type: Passive
Item Pool: Item Room
Strange Attractor
ItemID: 315
"Magnetic tears"
Quality: 0
Enemies and pickups (keys, bombs etc.) are now magnetically attracted to Isaac's tears
Can cause some enemies to have unpredictable movement
Type: Passive
Item Pool: Item Room
Cursed Eye
ItemID: 316
"Cursed charged shot"
Quality: 0
Tears are now charged up and fired rapidly in a burst of up to 5 shots at once
The amount of tears fired in the charge depends on how long you charge for
The eye has three states, white (not firing), black (first second of charging) and blinking between black and white. If you get hit while Cursed eye is a solid black colour you are guaranteed to be teleported to another random room on the floor. If you get hit in either of the other 2 states you will not be teleported
The Black Candle item will remove the Cursed Eye's teleportation effect
REPENTANCE - Burst now has 5 shots instead of 4
Type: Passive, Tear Modifier
Item Pool: Item Room, Secret Room
Mysterious Liquid
ItemID: 317
"Toxic splash damage"
Quality: 3
When Isaac's tears hit anything, they leave a green toxic creep on the floor that damages enemies for 1 damage per tick
Type: Passive
Item Pool: Item Room
Gemini
ItemID: 318
"Conjoined friend"
Quality: 1
A familar that is attached to Isaac, which will seek out and damage any enemies close by for 3 contact damage
Counts as 1 of 3 astrology items needed in the same run to unlock Planetariums
Type: Passive, Familiar
Item Pool: Item Room
Cain's Other Eye
ItemID: 319
"Near sighted friend"
Quality: 2
A familiar eye that follows Isaac and copies all his tear modifiers/effects, but shoots in random directions
Tears from this familiar deal 75% of Isaac's tear damage
Unlock this item by beating Boss Rush with Cain
Type: Passive, Familiar
Item Pool: Item Room
???'s Only Friend
ItemID: 320
"Controlled friend"
Quality: 2
A familiar fly that can be moved around via use of the arrow keys dealing 2.5 contact damage per tick, similar to the Ludovico Technique's mechanic
Counts as 1 of 3 fly items needed towards the Beelzebub transformation
Unlock this item by beating Boss Rush with Blue Baby
Type: Passive, Familiar
Item Pool: Item Room
Samson's Chains
ItemID: 321
"The ol' ball and chain"
Quality: 1
An iron ball and chain attached to Isaac, similar to Guppy's Hairball that you can fling around to deal 5 damage per tick
The ball will block enemy shots and can also destroy environmental objects such as rocks, mushrooms and skulls
Does not decrease your movement speed stat at all however the ball has to be dragged around causing Isaac to slow down slightly when the chain is fully extended
Unlock this item by beating Boss Rush with Samson
Type: Passive, Familiar
Item Pool: Item Room, Secret Room
Mongo Baby
ItemID: 322
"Mongo friend"
Quality: 2
A familiar that will follow Isaac and copy the effect of one of your other familiars
If you don't have any other familiars, he will just shoot normal tears
Counts as 1 of 3 familiar items needed towards the Conjoined transformation
REPENTANCE - Removed the double damage multiplier on Mongo Baby's attacks
Type: Passive, Familiar
Item Pool: Item Room
Isaac's Tears
ItemID: 323
"Collected tears"
Quality: 1
A spacebar item that fires 8 of Isaac's tears in a circle around him
Tears spawned from this item keep most effect that Isaac currently has applied to his tears, and deal an additional +5 flat damage
Unlock this item by beating the Isaac boss with Isaac
Type: Active
Recharge Time: 1 bar per tear fired
Item Pool: Item Room
Undefined
ItemID: 324
"Undefined"
Quality: 2
Upon use, teleports you to one of the following rooms at random: Item room, Secret room, Super secret room, the I AM ERROR room or the Black Market (very low chance)
There are no I AM ERROR rooms on the final floors, preventing looping with this item
Unlock this item by beating Boss Rush with Eden
Type: Active
Recharge Time: 6 rooms
Item Pool: Item Room
Scissors
ItemID: 325
"Lose your head"
Quality: 1
When used will cut your head from your body. Isaac's head will remain stationary and fire tears. His body can be controlled and spews blood nearby
Tears fired by the head do a flat 3.5 damage and don't scale
REPENTANCE - Scissors has been redesigned. The stationary head is now affected by Isaac's stats and attack modifiers, and the body will spew a controllable fountain of blood shots. Charge time increased to 4 (from 2)
Unlock this item by dying 100 times
Type: Active
Recharge Time: 4 rooms
Item Pool: Item Room
Breath of Life
ItemID: 326
"Invincibility at a cost"
Quality: 1
Holding the active item button will deplete the charge bar. When the charge bar gets to zero it will grant you a brief period of invincibility
If the spacebar is held for too long (about 1 second) when it has no charge, you will take damage
During the invincibility period, Isaac deals 3.5 contact damage to enemies and beams of light will strike down from the sky, dealing 15 damage
If damage is blocked perfectly at the exact second the charge bar reaches zero, it will release holy beams in four directions and grant a brief shile effect
The invincibility effect is shown via a rapid flashing animation
Type: Active
Recharge Time: Timed (1 bar per second)
Item Pool: Angel Room
The Polaroid
ItemID: 327
"Fate chosen"
Quality: 2
After taking damage, if you have half a red heart or less, The Polaroid will give you an invincibility shield for 5 seconds
Grants access to the Chest floor
Allows you to open the door at the beginning of Depths II that leads to the Mausoluem
When unlocked, is guaranteed to drop after the Mom's Foot boss fight
The Polaroid will always spawn on the left pedestal
Unlock this item by beating Isaac in the Cathedral 5 times
Type: Passive
Item Pool: None (Mom's foot boss only)
The Negative
ItemID: 328
"Fate chosen"
Quality: 2
+1.0 Damage Up
After taking damage, if you have half a red heart or less, The Negative will deal 40 damage to all enemies in the room
Gives you access to the Dark Room floor
Allows you to open the door at the beginning of Depths II that leads to the Mausoluem
When unlocked, is guaranteed to drop after the Mom's Foot boss fight
The Negative will always spawn on the right pedestal
Unlock this item by beating Satan in Sheol 5 times
Type: Passive
Item Pool: None (Mom's foot boss only)
The Ludovico Technique
ItemID: 329
"Controlled tears"
Quality: 2
You no longer shoot tears and instead now control a single large tear with the arrow keys
Items which increase your tears stat will cause the tear to deal damage at a faster rate
Items which increase your shot speed cause the tear to travel faster across the screen
Ludo and Brimstone create a large controllable red ring of death that does massive damage to anything in its path
Taking this with Mom's Knife allows you to remote control the knife around the room, dealing huge damage
Type: Passive, Tear Modifier
Item Pool: Item Room
Soy Milk
ItemID: 330
"DMG down + tears way up"
Quality: 2
Very high Tears Up: Tears * 5.5
-80% Damage Down
x0.5 Tear Size
REPENTANCE - Soy Milk tears now cause drastically less knockback
Type: Passive, Tear Modifier
Item Pool: Item Room
Godhead
ItemID: 331
"God tears"
Quality: 4
Isaac's tears become homing and have an aura around them, which will deal a flat 2 damage per tick to anything inside its radius
+0.5 Damage Up
-0.3 Tears Down
-0.3 Shot Speed Down
Multiple GodHeads doesn't stack the aura damage
Counts as 1 of 3 angel items needed towards the Seraphim transformation.
Unlock this item by completing all post-it note marks in hard mode with The Lost character
Type: Passive, Tear Modifier
Item Pool: Angel Room
Lazarus' Rags
ItemID: 332
"Eternal life?"
Quality: 1
Gives Isaac an extra life on death, exactly the same as Lazarus' default respawn effect
When you die with this item, you respawn in the same room with 1 heart and the Anemic item
The game considers you to be a different character (Lazarus II) when this effect activates
Unlock this item by beating the Isaac boss with Lazarus
Type: Passive
Item Pool: Item Room, Angel Room
The Mind
ItemID: 333
"I know all"
Quality: 3
Gives Isaac a full mapping effect, revealing the entire floor and locations of all secret rooms
Unlock this item by beating Satan with The Lost
Type: Passive
Item Pool: Item Room, Angel Room
The Body
ItemID: 334
"I feel all"
Quality: 3
+3 Health Up
The three heart containers are pre-filled with red hearts
Unlock this item by beating the Chest with The Lost
Type: Passive
Item Pool: Item Room, Angel Room
The Soul
ItemID: 335
"I am all"
Quality: 3
+2 Soul Hearts
Enemy projectiles will now slowly curve away from Isaac and avoid hitting him
Unlock this item by beating Dark Room with The Lost
Type: Passive
Item Pool: Item Room, Angel Room
Dead Onion
ItemID: 336
"Toxic aura tears"
Quality: 3
Isaac's tears become large, brown and will penetrate all objects and enemies (piercing + spectral)
-1.2 Range Down
-0.4 Shot Speed Down
x1.5 Tear Size
Despite the increase in tear size, Dead Onion does NOT increase your damage stat. It also doesn't do poison damage despite having the tagline 'toxic aura tears'
Type: Passive
Item Pool: Item Room
Broken Watch
ItemID: 337
"I think its broken"
Quality: 1
Upon entering every 4th unexplored room, the Broken Watch will either slow down or speed up all enemies in the room
The slow effect is much more common than the speed up
An item only found in the Shop item pool
Type: Passive
Item Pool: Shop
Boomerang
ItemID: 338
"It will never leave you"
Quality: 1
A blue boomerang which can be thrown in a similar fashion to Mom's Knife, to stun any enemies it hits and deal damage
The damage dealt by the Boomerang is equal to double your tear damage
The boomerang can also be used to grab pickups and consumables from a distance, similar to the legend of zelda boomerang
The range of the boomerang is affected by range, with number one the distance is very short and makes the item a lot less effective
The Boomerang can be used to kill shopkeeper corpses, allowing you to farm their drops for coins, items, Steam Sale etc
REPENTANCE - Boomerang is now piercing, and has far less downtime between throwing it and being able to fire tears again
Type: Active
Recharge Time: Timed (A few seconds)
Item Pool: Shop
Safety Pin
ItemID: 339
"Evil up + range + shot speed"
Quality: 1
+1.5 Range Up
+0.16 Shot Speed Up
+1 Black Heart
When depleted, Black Hearts deal 40 damage to the entire room, in a Necronomicon style effect
Type: Passive
Item Pool: Boss Room
Caffeine Pill
ItemID: 340
"Speed up + size down"
Quality: 1
+0.3 Speed Up
Decreases the size of Isaac, and your player hitbox, making you less likely to be hit
Gives you a random pill when picked up
An item only found in the boss room pool
Type: Passive
Item Pool: Boss Room
Torn Photo
ItemID: 341
"Tears + shot speed up"
Quality: 3
+0.7 Tears Up
+0.16 Shot Speed Up
Type: Passive
Item Pool: Boss Room, Gold/Stone Chest
Blue Cap
ItemID: 342
"HP + tears + shot speed down"
Quality: 3
+1 HP Up
+0.7 Tears Up
-0.16 Shot Speed Down
Heals one red heart container when picked up
An item only found in the Boss Room pool
Counts as 1 of 3 mushroom items needed towards the Fun Guy transformation
Type: Passive
Item Pool: Boss Room
Latch Key
ItemID: 343
"Luck up"
Quality: 1
+1 Luck Up
+1 Soul Heart
Spawns 2 keys on the ground
Type: Passive
Item Pool: Boss Room, Gold/Stone Chest, Key Beggar
Match Book
ItemID: 344
"Evil up"
Quality: 1
+1 Black Heart
+3 Bombs
When depleted, Black Hearts deal 40 damage to the entire room, in a Necronomicon style effect
REPENTANCE - Also drops the Match Stick trinket
Type: Passive
Item Pool: Boss Room, Gold/Stone Chest
Synthoil
ItemID: 345
"DMG up + range"
Quality: 3
+1.0 Damage Up
+1.5 Range Up
Counts as 1 of 3 syringe items needed towards the Spun transformation
Type: Passive
Item Pool: Boss Room
A Snack
ItemID: 346
"HP up"
Quality: 1
+1 HP Up
Heals one red heart container when picked up
Type: Passive
Item Pool: Boss Room
Afterbirth Items (95)
Diplopia
ItemID: 347
"Double item vision"
Quality: 3
A one-time use item which when used, will duplicate any pedestal items or consumables in the current room
If used in a shop, the duplicated items can be taken for free
If used on a trinket, another random trinket will spawn instead of a duplicate
If used in the Boss Rush, all the duplicates can be taken for free as well as one of the original items
If used in a Devil Room or Black Market, the duplicates can be taken for free
Type: Active
Recharge Time: Instant (One time use)
Item Pool: Shop
Placebo
ItemID: 348
"Pill mimic"
Quality: 2
When used, copies the effect of the pill you are currently holding without consuming it
The charge time of this item depends on the quality of the pill you're holding
Does not copy effects of Cards or Runes
Type: Active
Recharge Time: Varies
Item Pool: Shop, Greed Mode Shop
Wooden Nickel
ItemID: 349
"Flip a coin"
Quality: 1
When used, has a 50% chance to drop one random type of coin (penny, nickel or dime)
Keeper starts with this item after beating Isaac with Keeper
Unlock this item by donating 33 coins to the Greed Donation Machine
Type: Active
Recharge Time: 1 room
Item Pool: Shop, Greed Mode Item Room
Toxic Shock
ItemID: 350
"Mass poison"
Quality: 3
With this item, at the start of every room you will deal double your tear damage to the entire room in a poison effect
Enemies killed now also leave a pool of creep on the ground where they died. This deals 1 damage per tick
High tear damage will cause this item to become very powerful for rooms with a lot of enemies, since they can die instantly and render the room harmless
Enemies which spawn after the first few seconds of each room are not affected by this item, e.g. Flies spawned from a Mulligan dying
Type: Passive
Item Pool: Item Room
Mega Bean
ItemID: 351
"Giga fart!"
Quality: 1
When used, the Mega Bean will freeze all enemies in the current room for a couple of seconds, deal 5 damage and poison any enemies in close proximity and send a wave of spikes across the room in the direction you are facing
The enemies in close range will take 5 damage then have a poison over time effect which deals your tear damage 4 or 6 times
The spike wave will deal 10 damage to any enemies in contact with it
Can be used to open secret rooms
Type: Active
Recharge Time: 3 rooms
Item Pool: Item Room, Greed Mode Item Room
Glass Cannon
ItemID: 352
"Be gentle..."
Quality: 1
Glass Cannon allows you to fire one huge spectral tear that deals a lot of damage.
When taking damage, the cannon will break and remain broken until recharged (Recharge time: 4 rooms)
When you take damage and the cannon breaks, you take an additional 2 full hearts of damage and gain the Anemic effect for the room.
The damage done by Glass Cannon is calculated as follows: dmg = (dmg * 10) + 10 (i.e. at base damage of 3.5, that's 45 damage)
Self-inflicted damage such as Blood Donation machines don't trigger this effect
Type: Active
Recharge Time: 5 seconds
Item Pool: Item Room, Greed Mode Item Room
Bomber Boy
ItemID: 353
"Explosive blast!"
Quality: 2
+5 bombs
Isaac's bombs will now explode in a large cross-shaped pattern (roughly 5 bombs explosions wide)
This also affects troll bombs
Type: Passive
Item Pool: Item Room, Greed Mode Item Room, Bomb Beggar
Crack Jacks
ItemID: 354
"Don't swallow the prize!"
Quality: 2
+1 HP Up
Spawns a random trinket on the floor
Type: Passive
Item Pool: Boss Room, Gold/Stone Chest
Mom's Pearls
ItemID: 355
"Range + luck up"
Quality: 2
+0.38 Range Up
+1 Luck Up
+1 Soul Heart
Counts as 1 of 3 mom items needed towards the Mom transformation
Type: Passive
Item Pool: Boss Room, Gold/Stone Chest, Mom's Chest
Car Battery
ItemID: 356
"Double charge!"
Quality: 3
The Car Battery causes your spacebar item to activate twice on each use
For example, with Yum Heart you would heal 2 full red hearts instead of 1
Type: Passive
Item Pool: Shop, Greed Mode Shop
Box of Friends
ItemID: 357
"Double your friends"
Quality: 1
Upon use, gives you a duplicate of each familiar you have for the current room
It will not 'double' your familiars as the tagline suggests - if you have 2 of one kind, it will only give you an extra one
If the familiar only appears when taking damage (i.e. Dead Bird) then Box of Friends will cause it to spawn but won't create duplicates
This can be used multiple times in the same room to generate more familiars, meaning you can get a level 4 meatboy or bandage girl by using this item 3 times in the same room
If used when you have no familiars, it will give you a Demon Baby temporarily
Unlock this item by beating Greed Mode with Lilith
Type: Active
Recharge Time: 3 rooms
Item Pool: Shop, Greed Mode Item Room
The Wiz
ItemID: 358
"Double wiz shot!"
Quality: 0
Isaac wears a dunce hat and fires 2 tears at once diagonally, similar to the R U A WIZARD pill tear pattern
Gives Isaac spectral tears which allows them to travel through objects in the environment (i.e. rocks)
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
8 Inch Nails
ItemID: 359
"Stick it to 'em!"
Quality: 3
+1.5 Damage Up
Replaces Isaac's tears with nails, which have increased knockback
The increased knockback will also affect Brimstone, which usually has no knockback at all
Type: Passive, Tear Modifier
Item Pool: Item Room, Greed Mode Item Room
Incubus
ItemID: 360
"Dark friend"
Quality: 4
Gives you a familiar demon incubus that follows you and shoots tears that scale with your own tears in terms of damage, stats and also effects
It will mimic any tear effects you currently have and also copy your current stats, meaning it will fire with the same damage, fire rate and range
Lilith starts with this item
Incubus' damage is reduced by 25% when playing as characters other than Lilith
Counts as 1 of 3 familiar items needed towards the Conjoined transformation
Unlock this item by beating Blue Womb (Hush) with Lilith
Type: Passive, Familiar
Item Pool: Devil Room, Greed Mode Devil Room
Fate's Reward
ItemID: 361
"Your fate beside you"
Quality: 2
A familiar blue head that will follow Isaac and fire tears copying his tear damage and effects
This familiar is very similar to Incubus, however it only copies damage and is not affected by tears or range upgrades
Unlock this item by beating Blue Womb (Hush) with ??? (Blue baby)
Type: Passive, Familiar
Item Pool: Item Room
Lil Chest
ItemID: 362
"What's in the box?"
Quality: 2
A familiar chest that follows Isaac and has a 25% chance to drop a pickup after clearing a room
Possible drops include hearts, coins, bombs, key, pills, card, runes, batteries, trinket
There's a 10% chance to spawn a trinket
Unlock this item by beating Greed Mode with Isaac
Type: Passive, Familiar
Item Pool: Item Room, Greed Mode Item Room, Beggar
Sworn Protector
ItemID: 363
"Protective friend"
Quality: 3
An orbital angel which does 7 contact damage per tick and blocks shots
The angel will attract bullets towards it and block them
Sworn Protector will drop an eternal heart if it blocks 10 shots in one room. Can only happen once per room
Visually this is almost identical to the Guardian Angel item, but without a face
Counts as 1 of 3 angel items needed towards the Seraphim transformation
Counts as 1 of 3 familiar items needed towards the Conjoined transformation.
Unlock this item by beating Blue Womb (Hush) with The Lost
Type: Passive, Familiar
Item Pool: Angel Room, Greed Mode Angel Room
Friend Zone
ItemID: 364
"Friendly fly"
Quality: 1
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
Counts as 1 of 3 fly items needed towards the Beelzebub transformation
Type: Passive, Familiar
Item Pool: Item Room, Greed Mode Item Room, Key Beggar
Lost Fly
ItemID: 365
"Lost protector"
Quality: 2
A familiar fly that moves in a straight line and attaches itself to the first obstacle or wall it comes into contact with in each room.
If any enemies walk into its path, it will deal 7 contact damage every 7 frames
Nearby enemies will be forced to target and attack it
If the obstacle it is attached to is destroyed then it will continue rolling in the direction it was previously travelling until it meets another wall or obstacle
Type: Passive, Familiar
Item Pool: Item Room, Greed Mode Item Room, Key Beggar
Scatter Bombs
ItemID: 366
"We put bombs in your bombs!"
Quality: 1
+5 bombs
Causes your bombs to explode into 2-4 tiny bombs
The smaller bombs deal half damage and have a smaller explosion area. They also retain most of your bomb synergizing items
Type: Passive
Item Pool: Item Room, Greed Mode Item Room, Bomb Beggar
Sticky Bombs
ItemID: 367
"Egg sack bombs!"
Quality: 2
This item causes your bombs to stick to enemies and when exploding will leave white creep on the ground which slows enemies
When one of your bombs kills an enemy, a bunch of blue spiders are spawned to fight by your side, which deal x2 your current damage
+5 Bombs
Counts as 1 of 3 spider items needed towards the Spider Baby transformation.
Type: Passive, Bomb Modifier
Item Pool: Item Room, Greed Mode Item Room, Bomb Beggar, Bomb Beggar
Epiphora
ItemID: 368
"Intensifying tears"
Quality: 2
Shooting in one direction increases your fire rate until a cap is reached
The maximum effect is to halve your delay, which takes roughly 10 seconds to achieve
The accuracy of your tears is also reduced as your fire rate increases
As soon as you change firing direction, your fire rate is reset to its normal amount
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Continuum
ItemID: 369
"Transcendent tears"
Quality: 2
+3 Range Up
Tears will now travel through walls and appear out of the opposite wall, similar to a portal-type mechanic
Your tears can now also travel over rocks and objects in the environment
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Mr. Dolly
ItemID: 370
"Range + tears up"
Quality: 3
+0.7 Tears Up
+1.5 Range Up
Spawns 3 random types of hearts on the floor
Type: Passive
Item Pool: Boss Room, Gold/Stone Chest
Curse of The Tower
ItemID: 371
"You feel cursed..."
Quality: 0
Causes Isaac to spawn 6 troll bombs on the floor every time he gets hit, similar to the Anarchist Cookbook mechanic
Doesn't trigger on damage taken from blood donation machines and devil beggars (but still triggers on other forms of intentional self damage such as IV Bag)
Type: Passive
Item Pool: Item Room, Red Chest, Curse Room, Greed Mode Item Room
Charged Baby
ItemID: 372
"Bbbzzzzzt!"
Quality: 3
A familiar baby that has a random chance to drop a battery pickup or freeze all enemies in the room for a short while
Charged Baby also has a chance to add one charge to your spacebar item
These effects can only occur while in a hostile room with enemies
Type: Passive, Familiar
Item Pool: Shop, Greed Mode Shop
Dead Eye
ItemID: 373
"Accuracy brings power!"
Quality: 3
Gives Isaac a +25% damage up for every tear that successfully hits an enemy
The bonus from Dead Eye maxes out at double your damage (+100%)
If a tear misses an enemy, there is a chance for the multiplier to be reset back to 1. It's a 20% chance on first miss, 33% for a second miss and 50% for anything beyond that
Piercing shots work with this item and multiple hits with a single tear will each give a damage bonus
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Holy Light!
ItemID: 374
"Holy shot!"
Quality: 3
Isaac has a random chance to fire a Holy tear, which when it hits an enemy, will spawn a light beam on the same enemy, dealing damage
The beams from this item deal damage equal to 400% of your tear damage (4x damage multiplier for the beams only)
The chance to fire a Holy tear is affected by your luck stat, maxing out at a 50% chance
Counts as 1 of 3 angel items needed towards the Seraphim transformation.
Type: Passive
Item Pool: Item Room, Greed Mode Item Room, Angel Room
Host Hat
ItemID: 375
"Nice hat!"
Quality: 3
A familiar host that sits on Isaac's head and has a 20% chance to block enemy shots
When a shot is blocked, Host Hat will fire 3 bullets back at the enemy
Causes you to become immune to explosions, but doesn't protect against stomps or shockwaves
Blocks damage from projectiles falling from above
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Restock
ItemID: 376
"Never ending stores!"
Quality: 2
Causes your shops to instantly restock their items when you buy them
New items generated by Restock are from the shop item pool
The cost increases exponentially every time you purchase an item. For Items it increases by 2 coins * the number of purchases. For everything it increases by 1 coin * the number of purchases
The max price of an item is always 99c with this item
Works with Keeper's Box and the Member Card extra shop
Type: Passive
Item Pool: Shop, Beggar
Bursting Sack
ItemID: 377
"Spider love"
Quality: 1
Most spider enemies no longer target or deal contact damage to Isaac
This is very similar to a Skatole for spiders instead of flies
Counts as 1 of 3 spider items needed towards the Spider Baby transformation.
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
No. 2
ItemID: 378
"Uh oh..."
Quality: 2
Continuously firing or charging tears for 3 seconds causes Isaac to fart and drop a Butt Bomb
Only 1 Butt Bomb can be dropped per charge, so you'll need to stop firing then start again to drop another one
Butt Bombs explode for 50 damage like normal bombs, but also deal 10 damage to all enemies in the room and daze them for a short period of time
Counts as 1 of 3 poop items needed towards the Oh Crap transformation.
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Pupula Duplex
ItemID: 379
"Wide shot"
Quality: 2
Transforms Isaac's tears into a wide arc shape which doubles their size and hitbox
Gives Isaac spectral tears which allows them to travel through objects in the environment (i.e. rocks)
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Pay To Play
ItemID: 380
"Money talks"
Quality: 2
+5 coins
This item turns all doors that require a key into doors which need a coin to enter instead
This affects shops, item rooms, libraries, double locked doors, key blocks, chests and other key doors
Changes the appearance of doors and objects that this item works on to show a coin slot instead of a keyhole
Type: Passive
Item Pool: Shop, Greed Mode Item Room, Greed Mode Shop
Eden's Blessing
ItemID: 381
"Your future shines brighter"
Quality: 3
+0.7 Tears Up
Gives you a random item at the start of your next run (You need to start a fresh run to receive the item)
Important progression items such as Key Pieces or the Mom's Shovel pieces cannot be given by Eden's Blessing
Unlock this item by beating Blue Womb (Hush) with Eden
Type: Passive
Item Pool: Item Room
Friendly Ball
ItemID: 382
"Gotta fetch 'em all!"
Quality: 1
When used, can be thrown at enemies to capture them (similar to a PokƩ Ball)
After capturing an enemy, the next use of the Friendly Ball will re-spawn the same enemy as a friendly companion which will attack other enemies
The companion will persist between rooms and floors until it dies by taking enough damage
Walking over the thrown ball after capturing an enemy will immediately recharge it
Type: Active
Recharge Time: 2 rooms
Item Pool: Item Room, Greed Mode Item Room
Tear Detonator
ItemID: 383
"Remote tear detonation"
Quality: 1
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
Luck-based items such as Holy Light are applied to each tear individually
Type: Active
Recharge Time: 15 seconds
Item Pool: Shop, Greed Mode Item Room
Lil Gurdy
ItemID: 384
"A gurd of your own!"
Quality: 2
Gives Isaac a familiar Gurdy that will charge around the room dealing contact damage to enemies
The Gurdy is charged by holding down the fire button and letting go. The longer the button is held the faster Gurdy will fling itself across the screen
Deals a fixed amount of damage depending on charge level, at lowest being ~5 and at max being ~20
Lil Gurdy bounces off of enemies and obstacles
Type: Passive, Familiar
Item Pool: Item Room, Greed Mode Item Room
Bumbo
ItemID: 385
"Bumbo want coin!"
Quality: 1
A beggar head which floats around the room and picks up any nearby coins. Every 6 coins Bumbo will evolve to a new form except for level 4 which takes 12 coins
Level 2: Bumbo gains a body and crawls around the room, sometimes dropping random pickups
Level 3: It now fires tears in the same direction Isaac does
Level 4: Bumbo no longer fires tears but instead will chase enemies slowly and deal contact damage. It will also sometimes randomly drop bombs
After reaching level 4 (and at a much lower chance before level 4), Bumbo will also continue to collect coins and drop random pickups, similar to the Bum Friend item, but can also drop pedestal items very rarely.
Type: Passive, Familiar
Item Pool: Item Room, Beggar
D12
ItemID: 386
"Rerolls rocks"
Quality: 1
When used, the D12 re-rolls any rocks into another random type of object (e.g. poop, pots, TNT, red poop, stone blocks, spikes, fireplaces etc.)
Unlock this item by beating Blue Womb (Hush) with Cain
Type: Active
Recharge Time: 3 rooms
Item Pool: Item Room, Greed Mode Shop
Censer
ItemID: 387
"Peace be with you"
Quality: 3
Gives Isaac a familiar golden Censer which creates a huge aura of light that slows down any enemies inside it
Unlock this item by beating Greed Mode with Maggy
Type: Passive, Familiar
Item Pool: Angel Room, Greed Mode Angel Room
Key Bum
ItemID: 388
"He wants your keys!"
Quality: 0
A familiar beggar similar to Bum Friend that follows Isaac and collects keys, giving random chests in return
Doesn't pick up golden keys
Counts as 1 of 3 bum items needed towards the Super Bum transformation
Unlock this item by beating Greed Mode with Lazarus
Type: Passive, Familiar
Item Pool: Item Room, Secret Room, Key Beggar
Rune Bag
ItemID: 389
"Rune generator"
Quality: 3
A bag that follows Isaac and drops a random Rune or Soul Stone every 7 or 8 rooms
Unlock this item by beating the Isaac boss with Lilith
Type: Passive, Familiar
Item Pool: Item Room, Secret Room
Seraphim
ItemID: 390
"Sworn friend"
Quality: 3
A familiar angel which follows Isaac and fires Sacred Heart tears which deal 10 damage at -25% shot speed and a reduced fire rate
Counts as 1 of 3 familiar items needed towards the Conjoined transformation.
Type: Passive, Familiar
Item Pool: Item Room, Angel Room, Greed Mode Angel Room
Betrayal
ItemID: 391
"Turn your enemy"
Quality: 1
This item causes enemy projectiles to be able to hit other enemies. When an enemy takes damage from an enemy projectile, it will attempt to target the enemy that fired it
Unlock this item by beating Blue Womb (Hush) with Judas
Type: Passive
Item Pool: Item Room, Greed Mode Item Room, Devil Room, Greed Mode Devil Room
Zodiac
ItemID: 392
"The heavens will change you"
Quality: 1
Zodiac will give you a random zodiac item effect that changes after every floor
Possible item effects include: Taurus, Aries, Cancer, Leo, Virgo, Libra, Scorpio, Sagittarius, Capricorn, Aquarius, Gemini or Pisces
Counts as 1 of 3 astrology items needed in the same run to unlock Planetariums
Unlock this item by beating Greed Mode with The Lost
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Serpent's Kiss
ItemID: 393
"The kiss of death"
Quality: 2
Tears now have a random chance to apply a poison effect, dealing damage equal to your tears each tick, for 2 ticks
Isaac now deals poison damage on contact with enemies similar to The Virus item (Damage over time 4 or 6 per tick)
Enemies that were poisoned by contact damage have a 20% chance to drop a black sin heart when killed. Only contact poison has this effect - poison from tears doesn't work
Unlock this item by beating Satan with Lilith
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Marked
ItemID: 394
"Directed tears"
Quality: 1
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
Can be overridden by other tear modifiers such as Mom's Knife or Brimstone
Every time you leave the room this effect turns off until you press a shoot button again
+0.7 Tears Up
+3.0 Range Up
Has no effect with Lilith's Incubus
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Tech X
ItemID: 395
"Laser ring tears"
Quality: 4
Tears are replaced with the ability to charge and fire a laser ring that travels across the room
The size of the ring will depend on how long you charge it
The laser ring does damage scaling based on charge, from 25% at minimum to 100% at max
Rings have infinite range and travel until they hit a wall
Multiple Tech X stacks - every one taken adds another laser ring (doesn't affect your fire rate)
Type: Passive, Tear modifier
Item Pool: Item Room, Greed Mode Item Room
Ventricle Razor
ItemID: 396
"Short cutter"
Quality: 1
Allows you to create one brown tunnel and one blue tunnel in the floor, that can be used to teleport between wherever you placed each one
This item will let you port out of the devil room but not back into it
Very useful in the boss rush and challenge rooms
Type: Active
Recharge Time: Instant
Item Pool: Shop
Tractor Beam
ItemID: 397
"Controlled tears"
Quality: 3
Isaac's tears now travel directly forwards following a beam of light, but will also move sideways based on your player movement
+0.5 Tears Up
+1.5 Range Up
+0.16 Shot Speed Up
Allows for more accurate correction when firing tears, as their direction can be controlled even after they have been fired
If you switch the direction in which you are firing tears, the beam of light and all your tears will also be transported to the new direction
Type: Passive, Tear Modifier
Item Pool: Item Room, Greed Mode Item Room
God's Flesh
ItemID: 398
"Shrink shot!"
Quality: 1
Tears now have a random chance to apply a shrinking effect, causing enemies to shrink in size for 5 seconds and also run away from Isaac
Shrunk enemies can be crushed and killed by walking over them
Counts as 1 of 3 mushroom items needed towards the Fun Guy transformation
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Maw of The Void
ItemID: 399
"Consume thy enemy!"
Quality: 3
After firing tears for 3 seconds, a red cross appears on Isaac's head that, upon releasing the fire button, creates a black ring which deals a lot of damage to any enemies inside it
The ring deals damage equal to your tear damage rapidly to any enemies in contact with it, for a total of 30 ticks of damage
You have to keep the fire button held down for the full 3 seconds to cause this effect
Counts as 1 of 3 evil items needed towards the Leviathan transformation
Unlock this item by beating Blue Womb (Hush) with Azazel
Type: Passive
Item Pool: Devil Room, Greed Mode Devil Room
Spear of Destiny
ItemID: 400
"Your destiny"
Quality: 2
In addition to tears, Isaac now holds a spear infront of him which deals damage equal to 2 times your tear damage
The spear occasionally inflicts fear on enemies it damages.
The spear cannot be thrown like Mom's Knife but deals damage while it is in contact with an enemy
Type: Passive
Item Pool: Angel Room, Greed Mode Angel Room
Explosivo
ItemID: 401
"Sticky bomb shot!"
Quality: 3
Tears now have a random chance to become sticky bombs, which will attach to enemies and explode after a few seconds
The bomb explosion deals your tear damage + 60
Explosivo shots deal regular tear damage upon sticking to an enemy
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Chaos
ItemID: 402
"!!!"
Quality: 3
Causes all item pedestals to be chosen from a random item pool instead of the pre-defined ones which normally exist
When picked up, drops between 1-6 random pickups on the floor
Makes it possible to see items that have been rerolled away, preventing emptying the item pool and Breakfasting
Fixed item drops won't be replaced - e.g. Cube of Meat after defeating a Horseman
Chaos assigns a weight to item pools based on how many items are in the pool. The more items in a pool, the more likely that pool will be picked
Type: Passive
Item Pool: Shop, Secret Room
Spider Mod
ItemID: 403
"Mod buddy!"
Quality: 1
A familiar grey spider that wanders around and allows you to see your tear damage and the health bars of all enemies
The spider will inflict a random status effect on any enemies it comes into contact with (e.g. slow, shrink, fear)
Spider Mod will also randomly drop battery consumables or blue spiders when a room is completed
For the sake of simplicity for players, all damage values displayed are multiplied by 10 and rounded to the nearest number
This item is a reference to Spider853, creator of Spidermod for the original game and one of the lead developers that worked on Rebirth and its DLCs
Type: Passive
Item Pool: Shop, Greed Mode Shop
Farting Baby
ItemID: 404
"He farts!"
Quality: 1
A familiar that follows Isaac and blocks tears
If a tear hits Farting Baby, there is a 10% chance for it to fart, with 3 possible effects: Charm, Poison or Knock back
Charm deals 5 damage. Poison deals 5 damage initially and then 3.5
Counts as 1 of 3 familiar items needed towards the Conjoined transformation.
Unlock this item by beating Blue Womb (Hush) with Isaac
Type: Passive, Familiar
Item Pool: Item Room
GB Bug
ItemID: 405
"Game breaking bug, right away!"
Quality: 1
Spawns a familiar that follows Isaac.
Double tapping the fire button launches it forward, causing it to reroll the first monster, trinket, or pickup it hits
GB Bug respawns after a room has been cleared
Cannot reroll bosses - instead just deals 8 contact damage
Unlock this item by beating Greed Mode with Eden
Type: Passive
Item Pool: Item Room, Secret Room, Greed Mode Shop
D8
ItemID: 406
"Reroll stats"
Quality: 2
When used, the D8 rerolls all of your stats
Will only effect your damage, tears, range and speed stats
Each stat is given a multiplier that applies after all other adjustments
Unlock this item by beating Challenge #28 (Pride Day)
Type: Active
Recharge Time: 4 Rooms
Item Pool: Item Room, Greed Mode Shop
Purity
ItemID: 407
"Aura stat boost"
Quality: 3
Purity will boost one of Isaac's stats depending on the colour of the aura around him
When you take damage, the aura will be removed and replaced with another random one when you enter the next room
Colour code is as follows:
Red = +4.0 Damage
Blue = -4 Tear Delay
Yellow = +0.5 Speed Up
Orange = +3.0 Range Up
Unlock this item by beating Blue Womb (Hush) with Maggy
Type: Passive
Item Pool: Item Room, Angel Room, Greed Mode Item Room, Greed Mode Angel Room
Athame
ItemID: 408
"Call to the void"
Quality: 3
Adds a chance for a black ring to spawn around killed enemies, dealing damage to others that touch it
The ring damage scales with your tear damage
The chance for a ring to spawn scales with your luck stat
Unlock this item by beating Blue Womb (Hush) with Eve
Type: Passive
Item Pool: Devil Room, Curse Room, Greed Mode Devil Room
Empty Vessel
ItemID: 409
"I reward an empty vessel"
Quality: 2
+2 Black Hearts
When Isaac has no red hearts, this item gives Isaac the ability to fly. Every 40 seconds spent in the same room since last activating, when the timer displays 00, 20 or 40 seconds, a shield triggers, nullifying all types of damage for 10 seconds
As soon as Isaac has half a red heart or more, this item deactivates
Unlock this item by beating Blue Womb (Hush) with Lazarus
Type: Passive
Item Pool: Devil Room, Demon Beggar
Evil Eye
ItemID: 410
"Eye shot!"
Quality: 2
While firing tears this item gives you 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 evil eye shots will be destroyed if they come into contact with enemies or obstacles
Unlock this item by beating Greed Mode with Cain
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Lusty Blood
ItemID: 411
"Their blood brings rage!"
Quality: 3
Each time Isaac kills an enemy, you get a temporary +0.5 damage up which lasts for the current room
Each subsequent kill will stack further damage up to a maximum of +5 Damage Up after 10 kills
This item is the same principle as the Bloody Lust item from the original flash game
Unlock this item by beating Greed Mode with Samson
Type: Passive
Item Pool: Item Room, Devil Room, Greed Mode Item Room
Cambion Conception
ItemID: 412
"Feed them hate"
Quality: 2
After taking enough damage you will gain a permanent demon familiar
Possible familiars include: Dark Bum, Demon Baby, Leech, Lil' Brimstone, Succubus, Incubus, Lil Abaddon, Twisted Pair
The effect is shown visually in 3 stages with the character's belly getting larger each time until it finally gives birth to a familiar.
The first and second familiars spawn after 15 hits, then 30 hits for the third and fourth
Cambion Conception cannot grant more than 4 familiars in total
Lilith starts with this item
Unlock this item by beating ??? with Lilith
Type: Passive
Item Pool: Devil Room, Greed Mode Devil Room
Immaculate Conception
ItemID: 413
"Feed them love"
Quality: 1
After picking up 15 hearts, Isaac gains a permanent angelic familiar and a soul heart drops
Possible familiars include: Holy Water, Guardian Angel, Sworn Protector, The Relic and Seraphim
It is possible to get multiple followers by continuing to pick up hearts, at intervals of 15 hearts each
After all 5 familiars have spawned, it will just drop a soul heart every 15 hearts collected
Unlock this item by beating Boss Rush with Lilith
Type: Passive
Item Pool: Angel Room, Greed Mode Angel Room
More Options
ItemID: 414
"There are even more options!"
Quality: 3
Two items now spawn in each of your item rooms, however only one can be taken and the other will disappear
Doesn't work for half-sized item rooms
Type: Passive
Item Pool: Shop
Crown of Light
ItemID: 415
"The untainted gain power"
Quality: 4
+2 Soul Hearts
A crown that replaces normal tears with blue diamond tears while you don't have any empty red heart containers or bone hearts
While the effect is active, tears do double damage and have -0.30 Shot Speed
The crown will glow blue while active, if inactive it will appear grey
The effect will also deactivate for the rest of the current room when you take damage, regardless of your health
Type: Passive
Item Pool: Angel Room, Greed Mode Angel Room
Deep Pockets
ItemID: 416
"More stuff to carry!"
Quality: 2
Increases your money cap to 999
When a room clear would otherwise yield no rewards, it now spawns 1-3 pennies
Previously this item would add an extra card/pill slot, however this was removed with the Repentance rebalance
Unlock this item by beating The Chest floor with Keeper
Type: Passive
Item Pool: Shop, Greed Mode Item Room, Greed Mode Shop
Succubus
ItemID: 417
"Damage booster"
Quality: 3
A flying familiar that bounces around the room with a damaging aura, dealing rapid damage to any enemies inside it and boosting Isaac's tear damage
While standing in the black aura, Isaac has a temporary 1.5x damage multiplier (this will stack if you have more than one Succubus)
The aura deals 2.5 damage per tick or about 7.5 - 10 damage per second
Unlock this item by beating The Lamb with Lilith
Type: Passive, Familiar
Item Pool: Devil Room, Demon Beggar
Fruit Cake
ItemID: 418
"Rainbow effects!"
Quality: 3
Gives you a different tear effect with every tear that you fire
Tear effects include: Anti-Gravity, Ball of Bandages (Lvl 4), Bumbo (Lvl 3), Continuum, Cupid's Arrow, Compound Fracture, Euthanasia, Explosivo, Eye of Greed, Fire Mind, Flat Stone, Flat Worm, God's Flesh, Godhead, Head of the Keeper, Holy Light, Hook Worm, Ipecac, Iron Bar, Jacob's Ladder, Knockout Drops, Lachryphagy, Little Horn, Lodestone, Mom's Contacts, Mom's Eyeshadow, Mom's Perfume, Mucormycosis, My Reflection, Mysterious Liquid, Ocular Rift, Ouija Board, Ouroboros Worm, The Parasite, Parasitoid, Polyphemus, Pop!, Proptosis, Pulse Worm, Ring Worm, Rotten Tomato, Rubber Cement, Serpent's Kiss, Sinus Infection, Spider Bite, Strange Attractor, Sulfuric Acid, Technology Zero, Tiny Planet, Trisagion and Wiggle Worm
With Dr. Fetus, this item will also cycle through random Bomb Modifiers (e.g. Butt Bombs, Hot Bombs)
Type: Passive, Tear Modifier
Item Pool: Item Room
Teleport 2.0
ItemID: 419
"I-teleport!"
Quality: 3
When used will teleport you to another random room that has not been explored yet
After all the normal rooms have been explored, the hierarchy of rooms chosen is: Super Secret Room, Shop, Item Room, Sacrifice Room, Dice Room, Library, Curse Room, Miniboss, Challenge Room, Bedroom, Arcade, Vault, Secret Room, Devil/Angel Room, I AM ERROR
This ordering means a Devil and I Am Error room can both be forced if all others have been visited
If used in a normal room with enemies it will teleport you out and back into the exact same room
Type: Active
Recharge Time: 4 rooms
Item Pool: Item Room
Black Powder
ItemID: 420
"Spin the black circle!"
Quality: 1
Walking in a circle will spawn a pentagram symbol on the floor, which deals 10 damage per tick to any enemies inside it
The trail of black powder left on the floor will quickly disappear, meaning you are limited on the size of the pentagram symbol you can create
Will deal damage to flying enemies inside the pentagram
Type: Passive
Item Pool: Devil Room, Demon Beggar
Kidney Bean
ItemID: 421
"Love toots!"
Quality: 1
When used, applies the charm effect to any enemies in close range and deals 5 damage
Charmed enemies will prioritize attacking other enemies in the room, otherwise they will still attack Isaac
REPENTANCE - Kidney Bean now has a bigger effect radius, no longer deals damage to the enemies it's charming, and charge time has been reduced to 1 (from 2).
Type: Active
Recharge Time: 1 Rooms
Item Pool: Item Room, Greed Mode Item Room
Glowing Hour Glass
ItemID: 422
"Turn back time"
Quality: 3
When used, this item will rewind time and put you back in the previous room, in the same state you were in at that moment
This means any damage taken or consumables used in the current room will be reset back to the previous state
Can be used to check the contents of an Item Room without affecting Planetarium spawn chances
Glowing Hour Glass has no cooldown, but can only be used 3 times per floor
Type: Active
Recharge Time: None (Max 3 use per floor)
Item Pool: Item Room, Shop, Greed Mode Item Room
Circle of Protection
ItemID: 423
"Protect me from myself"
Quality: 2
Gives Isaac a large white halo around him, that deals a bit of damage to any enemies in contact with the ring
Every time an enemy bullet enters the ring, there is a chance it will reflect a homing tear back at the enemy
Type: Passive
Item Pool: Angel Room, Greed Mode Angel Room
Sack Head
ItemID: 424
"More sacks!"
Quality: 3
Coins have a 10% chance to be replaced with Sack. Bombs, keys, cards, runes and batteries have a 20% chance
Spawns a sack when picked up
Can lead to game-breaking combinations with the D20 due to the amount of consumables and batteries spawned by the item sacks
REPENTANCE - Added to the Secret Room pool
Type: Passive
Item Pool: Shop, Secret Room
Night Light
ItemID: 425
"Scared of the dark?"
Quality: 1
Gives Isaac a cone of light infront of him that slows any enemies inside it and their tears
The light faces the direction that you are facing, not the direction you are firing
Removes Curse of Darkness for the current floor, if picked up on a floor where the curse is active
Type: Passive
Item Pool: Shop, Greed Mode Item Room
Obsessed Fan
ItemID: 426
"Follows my every move..."
Quality: 0
A purple familiar fly that follows your exact movement on a 1 second delay and deals 2 contact damage to enemies
Counts as 1 of 3 fly items needed towards the Beelzebub transformation
Type: Passive, Familiar
Item Pool: Item Room, Key Beggar
Mine Crafter
ItemID: 427
"Booom!"
Quality: 1
When used, places an explosive TNT barrel next to you
The TNT barrel can be pushed and used to explode rocks or damage enemies
If used a second time in the same room while the last TNT barrel is still there, it will remotely explode the first TNT and not spawn another
Type: Active
Recharge Time: 1 room
Item Pool: Item Room
PJs
ItemID: 428
"You feel cozy"
Quality: 2
+4 Soul Hearts
Fully restores your red health
REPENTANCE - Added to the Gold Chest Pool
Type: Passive
Item Pool: Boss Room, Gold/Stone Chest
Head of the Keeper
ItemID: 429
"Penny tears!"
Quality: 2
Isaac's tears become coins and now have a 5% chance to drop pennies on the floor upon successfully hitting an enemy
Has a chance to drop when exploding a dead shopkeeper
Type: Passive
Item Pool: Dead shopkeeper
Papa Fly
ItemID: 430
"Turret follower"
Quality: 1
A familiar blue fly that will follow Isaac's movement pattern but delayed by 1 second
Papa Fly will fire tears at nearby enemies that deal damage equal to Isaac's tear damage
Counts as 1 of 3 fly items needed towards the Beelzebub transformation
Type: Passive, Familiar
Item Pool: Item Room, Key Beggar
Multidimensional Baby
ItemID: 431
"ydduB Buddy"
Quality: 2
A familiar baby that will follow your movement pattern on a 2 second delay
Tears that pass through the baby will double up and gain x1.33 speed boost
Counts as 1 of 3 familiar items needed towards the Conjoined transformation.
Type: Passive, Familiar
Item Pool: Item Room, Greed Mode Item Room, Devil Room, Greed Mode Devil Room
Glitter Bombs
ItemID: 432
"Prize bombs!"
Quality: 2
+5 bombs
Isaac's normal bombs become pink and causes them to drop random pickups when they explode (e.g. keys, coins, bombs, trinkets)
Bombs have a chance to charm enemies
The chance for pickups to spawn decreases by 1% each time Glitter Bombs provides something (resets at the next floor). This is to prevent a syngery like Dr. Fetus or a Golden Bomb giving you infinite resources
Type: Passive, Bomb Modifier
Item Pool: Item Room, Bomb Beggar
My Shadow
ItemID: 433
"Me! And my shaaaadow!"
Quality: 2
Isaac's shadow will follow closely behind him and when it comes into contact with enemies, will spawn friendly dark charger mobs
The chargers deal contact damage to enemies, and will be killed if it is hurt too much
Chargers disappear upon entering a new room
Unlock this item by beating Greed Mode with Judas
Type: Passive
Item Pool: Devil Room, Greed Mode Devil Room
Jar of Flies
ItemID: 434
"Gotta catch 'em all?"
Quality: 2
Every time you kill an enemy a fly will be added to the Jar, allowing you to stack up to 20
Using the Jar of Flies will release all the flies that are currently in the jar as friendly flies that will damage enemies
Counts as 1 of 3 fly items needed towards the Beelzebub transformation
Type: Active
Recharge Time: Instant
Item Pool: Shop, Greed Mode Item Room, Greed Mode Shop
Lil Loki
ItemID: 435
"4-way buddy!"
Quality: 1
A Loki familiar that follows Isaac and shoots tears 4 tears in a cross pattern, dealing a flat 3.5 damage each
Type: Passive
Item Pool: Item Room
Milk!
ItemID: 436
"Dont cry over it..."
Quality: 1
Gives Isaac a familiar glass of milk that follows him and spills on the floor upon taking damage
After being spilt, the milk gives you a -2 Tear Delay (Tears up) for the rest of the room
Type: Passive, Familiar
Item Pool: Item Room, Greed Mode Item Room
D7
ItemID: 437
"Reroll rewards!"
Quality: 1
When used, the D7 will restart the current room and bring back all enemies once again, enabling you to farm rewards that spawn at the end after beating the room
Can be used to generate infinite consumable combinations, gaining as many coins/keys/bombs as you need
This item has no effect in Greed Mode, Challenge Rooms and rooms that had no enemies in originally
If used in a Boss Room or Angel/Devil Room, you get teleported to another random room, which is reset instead of the boss/angel/devil room you were in
Enemies respawned by the D7 don't drop loot if they were champions and also don't grant score in daily run
Type: Active
Recharge Time: 3 rooms
Item Pool: Item Room
Binky
ItemID: 438
"Memories..."
Quality: 3
+1 Soul heart
+0.75 Tears Up
Isaac size down
Makes Isaac very small like a baby, reducing his hitbox size
Type: Passive
Item Pool: Boss Room, Gold/Stone Chest
Mom's Box
ItemID: 439
"What's inside?"
Quality: 2
When used, Mom's Box will drop a random trinket on the ground
+1 Luck while held
While held, doubles the effect of trinkets which make sense to be doubled (e.g. +4 damage from Curved Horn instead of 2, -4 Tear Delay from Cancer instead of 2)
Type: Active
Recharge Time: 4 rooms
Item Pool: Shop, Greed Mode Shop, Mom's Chest
Kidney Stone
ItemID: 440
"Matt's kidney stone"
Quality: 2
Randomly 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
REPENTANCE - Kidney Stone is no longer a speed downgrade
Unlock this item by beating Challenge #29 (Onan's Streak)
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Mega Blast
ItemID: 441
"Laser breath"
Quality: 4
Upon use, fires a huge Mega Satan laser for 15 seconds, dealing your tear damage * 5 per tick to anything in its path and pushing Isaac back by the force
The laser persists for the entire 15 seconds even between rooms and floors
This item appears in the Devil Room but is weighted to be about 5 times rarer than all other devil room items
Unlock this item by beating Mega Satan with every character
Type: Active
Recharge Time: 12 rooms
Item Pool: Devil Room, Greed Mode Devil Room
Afterbirth Plus Items (110)
Dark Prince's Crown
ItemID: 442
"Loss is power"
Quality: 1
A crown appears above your head and while at exactly 1 full red heart of health, you gain a +1.5 Range Up, +2.0 Tears Up and +0.20 Shot Speed Up
Any time your health changes to be not exactly 1 red heart you lose the effect
This item does nothing with The Lost
REPENTANCE - Dark Prince's Crown now grants more of an increase in rate of fire, and the bonus now breaks the soft tears cap.
Unlock this item by defeating Delirium as Azazel
Type: Passive
Item Pool: Devil Room, Curse Room
Apple!
ItemID: 443
"Trick or treat?"
Quality: 3
Gives you a 6.66% chance to fire a razor blade which deals x4 damage
+0.3 Tears Up
This item also turns your tears red, but does not change your actual damage stat or the damage your normal tears do
The chance to fire a razor blade depends on your luck stat, and at +14 luck you will fire a razor blade every time
Type: Passive
Item Pool: Item Room
Lead Pencil
ItemID: 444
"Hes a bleeder!"
Quality: 3
With every 15 tears fired, Isaac will fire a cluster of 12 tears instead of your normal tear
Causes your normal tears to fire out of one eye, which means tears will fire in a near-perfect line instead of slightly off-center
REPENTANCE - Lead Pencil's tear barrage no longer deals double damage
Type: Passive
Item Pool: Item Room, Gold/Stone Chest
Dog Tooth
ItemID: 445
"Bark at the moon!"
Quality: 2
+0.3 Damage Up
+0.1 Speed Up
When entering a room connected to a Secret Room or Super Secret Room, a howling sound will play
When entering a room with a crawl space trapdoor in it, a barking sound will play
Type: Passive
Item Pool: Item Room
Dead Tooth
ItemID: 446
"Halitosis"
Quality: 1
While firing, you gain a green aura that poisons any enemies which touch it. The poison deals your tear damage per tick, for 2 ticks
Has no effect on Lilith, as she cannot fire tears
Type: Passive
Item Pool: Item Room
Linger Bean
ItemID: 447
"Crying makes me toot"
Quality: 0
While firing tears constantly for 7.5 seconds, you spawn a poop cloud, which deals periodic damage to any enemies which come near it
The cloud deals damage equal to your base tear damage per tick, roughly 5 times per second
Clouds last 15 seconds before disappearing
The cloud can be pushed slightly by firing tears at it
Type: Passive
Item Pool: Item Room, Beggar
Shard of Glass
ItemID: 448
"Blood and guts!"
Quality: 1
Upon taking damage, Isaac starts to bleed, leaving a trail of blood and spraying blood tears everywhere which deal damage to nearby enemies
While bleeding, Isaac takes damage every 30 seconds
The blood sprays in the direction you are current firing, or just randomly near Isaac if not shooting your tears
The blood spray scales with your current tear damage and any future damage increases
This effect lasts until you pick up a red heart
Upon taking damage, this item gives a 25% chance to drop a full red heart
REPENTANCE - This entire item has been reworked
Type: Passive
Item Pool: Item Room
Metal Plate
ItemID: 449
"It itches..."
Quality: 1
+1 Soul Heart
Enemy bullets have a 25% chance to be deflected back at the enemy, which will hurt them and apply the concussive status effect, causing it to be stunned for a few seconds
Type: Passive
Item Pool: Item Room
Eye of Greed
ItemID: 450
"Gold tears!"
Quality: 2
Every 20th tear fired will also fire a golden coin tear at the same time. This tear turns enemies to gold for a few seconds and causes them to drop 1-4 coins if killed while golden (similar to the Midas' Touch item)
When the Midas Touch tear effect triggers, it will remove 1 coin from your current total
The golden tear deals double your tear damage
The effect can still trigger even if you have no held coins
Unlock this item by defeating Greedier Mode with Keeper
Type: Passive
Item Pool: Secret Room
Tarot Cloth
ItemID: 451
"I see the future"
Quality: 2
Drops a random card on pickup
Doubles the effect of most tarot cards. A slow pulsing outline HUD effect appears for cards that would be buffed by Tarot Cloth
To see the full list of Tarot Card effects, check out the Mechanics > Tarot Cloth page
Counts as 1 of 3 astrology items needed in the same run to unlock Planetariums
Type: Passive
Item Pool: Shop, Curse Room
Varicose Veins
ItemID: 452
"I'm leaking..."
Quality: 1
Every time you take damage, 10 high damage tears are fired in a circle around you (similar to the Tammy's Head effect)
Tear damage is equal to Isaac's tear damage + 25 flat damage
Additionally, has a chance to activate the Anemic effect when taking damage for 2 seconds
Similar to Tammy's Head, this item synergizes with a lot of items (i.e. with Brimstone it fires 10 lasers)
Type: Passive
Item Pool: Item Room
Compound Fracture
ItemID: 453
"Bone tears!"
Quality: 3
Turns your tears into bones, which shatter into 1-3 smaller bone shards upon hitting any object or enemy
The smaller bone shards deal damage equal to half your normal tear damage
+0.38 Range Up
Unlock this item by defeating Delirium in The Void floor with Lazarus
Type: Passive
Item Pool: Item Room
Polydactyly
ItemID: 454
"Hold me!"
Quality: 2
Allows Isaac to carry two cards, runes or pills (or any combination of these) at the same time
Drops a random card, pill or rune on pickup
Type: Passive
Item Pool: Item Room
Dad's Lost Coin
ItemID: 455
"I remember this..."
Quality: 1
+0.38 Range Up
Drops a lucky penny
Unlock this item by beating Greedier Mode with The Lost
Type: Passive
Item Pool: Boss Room, Beggar, Gold/Stone Chest
Midnight Snack
ItemID: 456
"HP up"
Quality: 1
+1 HP Up
REPENTANCE - This was renamed from Moldy Bread
Type: Passive
Item Pool: Boss Room, Beggar, Gold/Stone Chest
Cone Head
ItemID: 457
"Hard headed!"
Quality: 2
+1 Soul Heart
Each time you take damage from any source, Cone Head has a 20% chance to prevent it from reducing your health
Isaac flashes blue very briefly when damage is negated by this item
Type: Passive
Item Pool: Item Room
Belly Button
ItemID: 458
"Whats in there?"
Quality: 3
Drops one random trinket on pickup
Gives you an extra trinket slot
Type: Passive
Item Pool: Item Room
Sinus Infection
ItemID: 459
"Booger tears!"
Quality: 3
Isaac's tears have a 20% chance to be a booger instead, which stick on to enemies and deal periodic poison damage until they die
Each tick of poison damage is equal to your normal tear damage
Each booger persists for 10 seconds or until the enemy dies
Type: Passive
Item Pool: Item Room
Glaucoma
ItemID: 460
"Blind tears!"
Quality: 1
Adds a chance to shoot a concussive tear, which will cause enemies to walk around dazed in confusion
The daze effect is effectively permanent for normal enemies, and has a much longer duration for bosses compared to other status effects
Makes all rooms slightly darker
The visual effect of a Glaucoma tear is hard to notice, however it is slightly lighter than normal tears and is not a perfect circle shape
Type: Passive
Item Pool: Item Room
Parasitoid
ItemID: 461
"Egg tears!"
Quality: 3
This item gives you a chance that instead of firing tears you will fire an egg sack, which slows enemies on hit and drops a pool of white slowing creep below them
If a parasitoid shot successfully hits an enemy, a blue friendly fly or spider is spawned
Counts as 1 of 3 fly items needed towards the Beelzebub transformation.
Counts as 1 of 3 spider items needed towards the Spider Baby transformation.
Type: Passive
Item Pool: Item Room
Eye of Belial
ItemID: 462
"Possessed tears!"
Quality: 3
Causes your tears to become piercing, allowing them to travel through enemies
After hitting its first enemy, each tear will double in damage and gain a homing effect
+0.38 Range Up
Unlock this item by defeating Greedier Mode with Judas
Type: Passive
Item Pool: Devil Room
Sulfuric Acid
ItemID: 463
"Acid tears!"
Quality: 2
+0.3 Damage Up
Each tear has a chance to become acidic, allowing it to break rocks, pots and other breakable objects
Acidic tears can also be used to open secret rooms
Type: Passive
Item Pool: Item Room
Glyph of Balance
ItemID: 464
"A gift from above"
Quality: 2
+2 Soul Hearts
This item will modify drops from room clearing and champion enemies based on your current player state. The priority list of what will drop from champion enemies in order is as follows:
Soul Hearts - When you have no red heart containers and less than 2 soul hearts
Red Hearts (Full hearts) - While at 0.5 red hearts
Keys - When you have no keys
Bombs - When you have no Bombs
Red Hearts (Full hearts) - When you have at least half a red heart container empty
Coins - While at less than 15 cents
Keys - When you have less than 5 keys
Bombs - When you have less than 5 bombs
Trinkets - If you have no trinkets and there are no trinkets on the ground in the room
Soul Hearts - When you have less than 6 total heart containers of any kind
If none of the above conditions are true, champions will resume dropping their regular pickups
Unlock this item by defeating Greedier mode with Maggy
Type: Passive
Item Pool: Angel Room
Analog Stick
ItemID: 465
"360 tears!"
Quality: 2
+0.35 Tears Up
Allows you to fire tears diagonally by holding down two of the fire buttons at once
If you are using a gamepad, this item allows you to fire in any direction
Type: Passive
Item Pool: Item Room
Contagion
ItemID: 466
"Outbreak!"
Quality: 2
The first enemy you kill in each new room will now explode and poison all nearby enemies, causing them to take periodic damage until they also die and explode
If you have lots of enemies near each other this can cause a chain reaction, killing lots of enemies in one go
Type: Passive
Item Pool: Item Room
Finger!
ItemID: 467
"Watch where you point that!"
Quality: 1
Gives Isaac a finger which floats infront of him and points in the same direction he is facing or firing. The finger deals 10% of your normal damage to all enemies in the same direction that the finger is pointing
The finger will also deal damage to entities such as fires and poops
Applies on-hit status effects such as the burning debuff from Fire Mind
Spawns guppy flies if you have the Guppy transformation
Type: Passive, Familiar
Item Pool: Item Room
Shade
ItemID: 468
"It follows"
Quality: 0
Isaac gains a shadow familiar that will follow Isaac's movement pattern by a 0.66 second delay and deal 5 contact damage to enemies per tick
Shade is absorbed by Isaac after dealing over 666 damage. This spawns friendly charger enemies and causes Isaac to deal 5 contact damage (same as the shade did). This effect stacks with multiple shades, scaling the contact damage each time
Unlock this item by defeating Delirium in The Void floor with Judas
Type: Passive, Familiar
Item Pool: Devil Room, Curse Room
Depression
ItemID: 469
":("
Quality: 1
Isaac gains a cloud familiar that follows him and leaves a trail of tears on the floor which damages enemies for 2 damage per tick
Enemies touching the cloud have a chance to activate the Crack the Sky effect, which spawns a light beam that deals damage equal to your tear damage + 20
Type: Passive, Familiar
Item Pool: Item Room
Hushy
ItemID: 470
"Lil hush!"
Quality: 0
Gives Isaac a small Hush familiar that bounces diagonally around the room dealing 2 contact damage per tick
While you're firing tears Hushy will stop moving, which allows you to keep it in one place
Hushy will block enemy tears and projectiles
Unlock this item by beating Hush with Apollyon
Type: Passive, Familiar
Item Pool: Item Room
Lil Monstro
ItemID: 471
"Ain't he cute?"
Quality: 2
Gives Isaac a small Monstro familar, who's tears can be charged and released in a shotgun style effect, much like Monstro's main attack
Lil Monstro's tears each deal base damage (3.5) and do not scale with damage upgrades
Type: Passive, Familiar
Item Pool: Item Room
King Baby
ItemID: 472
"Lord of the dead!"
Quality: 1
A baby familiar that follows you and causes other familiars to follow it. It stops moving while Isaac is firing tears and upon releasing the fire button, King Baby will teleport back to your location
King Baby will always appear first in the queue of familiars
Counts as 1 of 3 familiar items needed towards the Conjoined transformation.
REPENTANCE - Familiars now automatically aim at enemies when being commanded by King Baby
Unlock this item by beating Delirium on The Void floor with ???
Type: Passive, Familiar
Item Pool: Shop
Big Chubby
ItemID: 473
"Chub chub"
Quality: 2
A familiar that follows Isaac and charges forwards very slowly, dealing 2.7 damage per tick to any enemies it comes into contact with
Almost identical to the Little Chubby familiar, but this one moves much more slowly and deals less damage
REPENTANCE - The damage tick rate on Big Chubby has been increased
Type: Passive, Familiar
Item Pool: Item Room
Plan C
ItemID: 475
"My last resort"
Quality: 0
Upon use, this item deals 9,999,999 damage to all enemies in the room and then kills you 3 seconds later
This is a single use active item, meaning it is destroyed after using it
Does not kill both phases of multi-phase bosses like Hush or Ultra Greed
If used to kill a boss, the kill still counts as a victory for post-it note completion marks, but the run will still get a game over
Delirium's death animation takes longer than 3 seconds, meaning you will die before it can count as a completion mark. One exception to this is if you are playing as Lazarus or have Lazarus' Rags - you will respawn in the same room and get the kill
Plan C is 5 times rarer than other items in the same item pool, making it less likely to appear
Unlock this item by defeating Greedier Mode with Lazarus
Type: Active
Recharge Time: One time use
Item Pool: Shop, Devil Room, Curse Room, Red Chest, Demon Beggar
D1
ItemID: 476
"What will it be?"
Quality: 2
When used, the D1 duplicates 1 random pickup in the current room. This works with all normal pickups, including cards, runes, chests and trinkets. Duplicated items might not be identical copies of the original - for example duplicating a card may spawn a different card
Jera runes and trinkets cannot be duplicated using the D1
Duplicated chests can turn into another kind of chest randomly (e.g. Red chests)
Can be used in a shop to duplicate pickups which have not yet been purchased, and take the duplicate pickup for free
Unlock this item by defeating Greedier Mode with Isaac
Type: Active
Recharge Time: 4 rooms
Item Pool: Item Room
Void
ItemID: 477
"Consume"
Quality: 4
When used, Void will consume any pedestal items in the current room
If an active item is consumed, its effect will be added to Void's effect when used, allowing you to consume multiple items and combine their effects
If a passive item is consumed, you gain a small stat upgrade to a random stat
Possible stat changes include: +1.0 flat damage, +0.5 tears, +0.2 speed, +0.2 shot speed, +0.5 range, +1.0 luck
Void does not work on devil deal or shop items unless they have been bought first
Using Void to absorb items in Boss Rush or Challenge Rooms counts as taking the items and will cause the encounter to start
Using Void on one time use items such as Mama Mega or Diplopia will cause their effect to instantly trigger and will not give you further uses through activating Void again
Unlock this item by beating Delirium in The Void floor with Apollyon
Type: Active
Recharge Time: 6 rooms
Item Pool: Devil Room, Angel Room
Pause
ItemID: 478
"Stop!"
Quality: 1
Upon use, this item freezes all enemies in the room until you press the fire button again or 30 seconds passes (whichever happens first)
Unlike other active items, bosses are not immune to this effect
Touching a frozen enemy will still hurt you
This item doesn not affect troll bombs - they will still explode
Type: Active
Recharge Time: 2 rooms
Item Pool: Item Room
Smelter
ItemID: 479
"Trinket melter!"
Quality: 3
Upon use, the Smelter will destroy your currently held trinket and give you the effect permanently, allowing you to stack up lots of different trinket effects
Holding the Smelter increases the chance for a trinket to drop. (2% chance for the end of room drop to become a trinket)
If a trinket has been smelted, it won't appear a second time unless the entire trinket pool is exhausted or you restart the run (e.g. by doing a victory lap)
Unlock this item by beating Mom's Heart on Hard Mode with Apollyon
Type: Active
Recharge Time: 6 rooms
Item Pool: Shop
Compost
ItemID: 480
"Gain more friends!"
Quality: 1
When used, Compost doubles up the current number of blue flies and spiders you have
When picked up, Compost will also destroy every consumable on the ground in the current room and turn each of them into a blue fly or blue spider
If you have no pickups on the ground in the current room and no other flies or spiders, Compost will spawn 1 blue fly or blue spider
Type: Active
Recharge Time: 2 rooms
Item Pool: Shop
Dataminer
ItemID: 481
"109"
Quality: 0
When used, this item will distort all the sprites and music, rotating graphics 90 degrees and translating them diagonally up/left, while leaving the hitbox in the same place. This can make it confusing while navigating the room
Enemy hitboxes remain the same
Dataminer will randomly increase or decrease one of your stats by a small amount when used
Gives you the Fruit Cake effect for the room when used, which will give a random tear effect with every tear fired
All visual and tear effects reset after leaving the room
Type: Active
Recharge Time: 4 rooms
Item Pool: Item Room
Clicker
ItemID: 482
"Change"
Quality: 0
When used, this item will randomly change you into another character and remove the last item you picked up
All stat changes of the new character are applied (e.g. character damage multipliers)
This item can only reduce your heart containers and will not increase them if you change back into a character with more health. This means if you roll into The Lost, changing back to another character will leave you with only 1/2 of a soul heart
Cannot turn you into a character that isn't unlocked yet
Also includes Lazarus II (Lazarus' revived form) and Dark Judas (effect of Judas' Shadow)
It's also possible that this item will pick the same character, making it seem like nothing happened
Type: Active
Recharge Time: 6 rooms
Item Pool: Item Room
MaMa Mega!
ItemID: 483
"BOOOOOOOOOM!"
Quality: 3
A one time use item that when used will explode all objects (i.e. rocks, poop) in the room and deal 200 damage to all enemies in the current room, as well as every other room for the remainder of the floor
Also opens the boss rush door after Mom's Foot, blue womb door after Mom's Heart, secret rooms and super secret rooms
Like all single-use items, this item cannot be absorbed and used multiple times by the Void item
Entering a room with an angel statue will destroy it and automatically spawn one of the Angel mini bosses
REPENTANCE - This now blows up machines, beggars and fireplaces too
Type: Active
Recharge Time: One time use
Item Pool: Shop, Bomb Beggar
Wait What?
ItemID: 484
"I can't believe it's not butter bean!"
Quality: 1
Upon use, this item will fart, pushing enemies away and causing a wave of rocks to spawn that spread outwards from Isaac in a circle, dealing 10 damage per hit to any enemies caught in it
Can be used to open secret rooms
Visually this item is very similar to Butter Bean
The rock waves can destroy destructible objects, e.g. poop
Type: Active
Recharge Time: 10 seconds
Item Pool: Item Room
Crooked Penny
ItemID: 485
"50/50"
Quality: 2
When used, you have a 50% chance to double all items, consumables and chests in the current room
If the effect fails, all pickups and items are deleted and Crooked Penny spawns 1 coin
If there are no consumables currently on the floor, Crooked Penny spawns 1 coin
This item works with items which can be purchased such as shop items, allowing you to spawn a free version if the effect triggers
If used in a shop and the effect fails, a Restock box can be used to restore the shop items. This mechanic is very useful on Greed and Greedier modes
Unlock this item by defeating Delirium in The Void floor with Keeper
Type: Active
Recharge Time: 4 rooms
Item Pool: Item Room, Shop, Beggar
Dull Razor
ItemID: 486
"I feel numb..."
Quality: 1
Upon use this item hurts Isaac without actually taking health away, allowing you to activate any items which trigger when taking damage without losing health
Unlock this item by defeating Delirium on The Void floor with Eve
Type: Active
Recharge Time: 2 rooms
Item Pool: Shop
Potato Peeler
ItemID: 487
"A pound of flesh..."
Quality: 2
When used, this item permanently removes one of your red heart containers and gives you a flat +0.2 Damage Up, the Anemic effect (+1.5 Range Up + red creep trail) and a Cube of Meat
The Anemic effect will only last for the current room, but the Cube of Meat and Damage Up are both permanent
Only works for red hearts and has no effect when used if you only have soul/black hearts
Has no recharge time and can be used as often as you like
It is possible to generate multiple meatboys by stacking more than 4 Cubes of Meat
Type: Active
Recharge Time: None
Item Pool: Shop, Demon Beggar
Metronome
ItemID: 488
"Waggles a finger"
Quality: 1
When used, this item gives you the effect of a random item for the rest of the room
Using this item multiple times in the same room will replace the previous item's effect with a new one
Certain items can be activated with this item which have unexpected effects and many items will do nothing
Items do not grant consumable drops which would normally occur when that item is picked up
Most flight-granting items have cosmetic effects only, and will not allow you to fly
Items that usually give HP up will not give extra health when gained from Metronome
Unlock this item by defeating Greedier Mode with Eden
Type: Active
Recharge Time: 2 rooms
Item Pool: Item Room
D Infinity
ItemID: 489
"Reroll forever"
Quality: 4
This dice allows you to press the Drop key to cycle between all possible dice effects and pick one to use
Charge time scales based on the chosen dice, updating every time you use it
Possible dice include: D1, D4, D6, D8, D10, D12, D20, D100
REPENTANCE - This item was completely reworked for Repentance and no longer forces a random dice use each time. You can pick which dice you want to use.
Unlock this item by defeating Delirium in The Void floor with Isaac
Type: Active
Recharge Time: Varies
Item Pool: Secret Room
Eden's Soul
ItemID: 490
"..."
Quality: 3
A one time use active item that when used, will spawn 2 random item pedestals from the item pool associated with the current room (e.g. in an Angel room, this will spawn 2 Angel room items)
Starts with 0 charge and requires 12 charges to use
Unlock this item by defeating Delirium in The Void floor with Eden
Type: Active
Recharge Time: 12 rooms (one time use)
Item Pool: Angel Room
Acid Baby
ItemID: 491
"Pills pills pills!"
Quality: 2
Every 6-7 rooms Acid Baby will drop a random pill
The first pill drops after 2 rooms
Every time you use a pill, Acid Baby will deal 10 damage to all enemies and poison them for 6-7 ticks
Counts as 1 of 3 familiar items needed towards the Conjoined transformation.
REPENTANCE - Poison effect is stronger, but Acid Baby's pill drop rate has been reduced to every 6-7 rooms (previously every 2-3 rooms)
Type: Passive, Familiar
Item Pool: Item Room
YO LISTEN!
ItemID: 492
"Yo listen!"
Quality: 2
+1 Luck Up
A familiar fairy that will float around the room and highlight the location of any secret room doors, tinted rocks or trapdoors under rocks
Upon entering a new room, if there is an undiscovered secret room or tinted rock, it will move directly to the point of interest, otherwise it will just randomly fly around the room
Counts as 1 of 3 fly items needed towards the Beelzebub transformation.
Type: Passive, Familiar
Item Pool: Item Room, Key Beggar
Adrenaline
ItemID: 493
"Panic - power"
Quality: 2
For every empty red heart container, Isaac gains Damage Up and his body increases in size
Only works on full hearts - damage does not change if Isaac is missing 1/2 of a heart in one container
Healing empty red heart containers will remove the damage increases
Has no effect for The Lost and ???, as they cannot gain red heart containers (except for counting towards the Spun transformation)
Counts as 1 of 3 syringe items needed towards the Spun transformation
REPENTANCE - Adrenaline now grants an increasingly higher damage bonus the more empty heart containers Isaac has
Type: Passive
Item Pool: Item Room, Demon Beggar
Jacob's Ladder
ItemID: 494
"Electric tears"
Quality: 3
Isaac gains electric tears, which fire 1-2 sparks of electricty in random directions upon hitting any object or enemy
The electricity will chain between nearby enemies
The electricty deals half of your normal tear damage
Tear effects will still apply to your electricty sparks in a lot of cases. Spoon Bender will give them a homing effect, and status effects like fear/poison will spread onto all enemies the electricity chains to
Tears which fall naturally to the floor at max range do not generate sparks
It's possible to fire tears at a wall to create electricity that damages enemies on the other side of the wall
Type: Passive
Item Pool: Item Room
Ghost Pepper
ItemID: 495
"Flame tears"
Quality: 4
Each tear now has a small chance to be a spectral blue flame instead, which deals damage to enemies that come in contact with it
The fire will remain in place and shrink in size when deals damage to something. After dealing enough damage it will eventually disappear
At full size the flame deals 6x your tear damage, scaling down to 3x at its smallest size
The chance to for each tear to become a flame is affected by your luck stat and at +10 Luck it will activate 50% of the time (starts at 8.33% at +0 Luck)
Type: Passive
Item Pool: Item Room
Euthanasia
ItemID: 496
"Needle shot"
Quality: 3
Each tear now has a small chance (3.33%) to be a needle instead, which deals 3 times your tear damage
If a needle hits a non-boss enemy it will instantly kill it and will explode into a circle of 10 more needles
The 10 spawned needles will also deal 3 times your tear damage, but won't instantly kill enemies or explode into more needles
The chance to for each tear to become a needle is affected by your luck stat and at +15 Luck it will activate 50% of the time
Counts as 1 of 3 syringe items needed towards the Spun transformation
Unlock this item by defeating Delirium in The Void floor with Lilith
Type: Passive
Item Pool: Item Room, Curse Room, Demon Beggar
Camo Undies
ItemID: 497
"Camo kid"
Quality: 3
Upon entering a new room, Isaac will become camouflaged and enemies won't attack until you start firing tears
Bosses are immune to this effect
Camo Undies grants +0.5 speed while cloaked
When uncloaking, all nearby enemies take damage, and Isaac gains a brief tears + damage up
Type: Passive
Item Pool: Item Room
Duality
ItemID: 498
"You feel very balanced"
Quality: 1
Any time a devil or angel room door opens after a boss, the other one will also spawn
The extra door will only spawn if a devil or angel room was randomly chosen to spawn already
After entering one of the doors, the other will disappear
If there isn't an available wall for the extra door to spawn on, only one door will spawn (i.e. in a small boss room)
Unlock this item by defeating Greedier Mode with Lilith
Type: Passive
Item Pool: Devil Room, Angel Room
Eucharist
ItemID: 499
"Peace be with you"
Quality: 3
Gives you a 100% chance to find an Angel Room on every valid floor after defeating the boss
Doesn't spawn an angel room on any floor where it is normally not possible to find one (e.g. Basement 1, Cathedral, Sheol etc.)
Keeps the chance at 100% even after entering and leaving the angel room, meaning the door will not close after visiting
Makes it impossible to find Devil Rooms again, unless you find a way to remove or reroll this item away, or find the Duality item
Unlock this item by defeating Delirium in The Void floor with Maggy
Type: Passive
Item Pool: Angel Room
Sack of Sacks
ItemID: 500
"Gives Sacks!"
Quality: 3
A sack familiar that drops a sack every 5 or 6 rooms cleared (alternates between 5 and 6)
Unlock this item by defeating Greedier Mode as Cain
Type: Passive, Familiar
Item Pool: Secret Room
Greed's Gullet
ItemID: 501
"Money = Health!"
Quality: 1
Gives you an extra heart container for every 25 coins you are currently holding, up to a maximum of 4 extra HP at 99 coins held
If your coin counter goes below the required amount for a heart container, you will lose it again
This item works for the Keeper, allowing him to exceed his usual 2 health containers
However, if Keeper drops to under 2 health coins as a result of Greed's Gullet, he is unable to use a HP Up to increase his health back to 2, and has to regain the lost coins to do so
Unlock this item by beating Challenge #35 (Pong)
Type: Passive
Item Pool: Secret Room
Large Zit
ItemID: 502
"Creep shots"
Quality: 1
Gives you a random chance while firing tears to also fire a creep shot, which deals double your tear damage and places white creep on the floor infront of you that slows enemies down if they walk through it
Unlike some similar tear effects, your luck stat does not alter the chance for this effect to activate
A creep shot is also fired in a random direction after taking damage
Type: Passive
Item Pool: Item Room
Little Horn
ItemID: 503
"Big brother is watching"
Quality: 3
While firing tears you have a 5% chance to fire a void tear. Void tears that touch enemies will spawn Big Horn, who appears and grabs them, instantly killing that enemy
The chance to for each tear to become a void tear is affected by your luck stat and at +15 Luck it will activate 20% of the time
Isaac also grows a horn on his head, which causes you to deal contact damage to enemies by running into them (this effect deals base damage of 3.5 per tick)
Void tears from this item can also destroy blue/purple fires, spiked blocks and stone grimaces
Type: Passive
Item Pool: Devil Room, Curse Room, Demon Beggar
Brown Nugget
ItemID: 504
"Friendly Fly"
Quality: 0
When used, will spawn a fly turret that doesn't move and fires tears at nearby enemies
Only persists for the current room
The fly's bullets deal 3.5 damage each and do not scale with your own damage stat
REPENTANCE - Brown Nugget flies now have faster shot speed, and their damage has been increased to 3.5 (from 2).
Unlock this item by defeating Ultra Greed as Apollyon
Type: Active
Recharge Time: 7 seconds
Item Pool: Item Room
Poke Go
ItemID: 505
"Gotta catch em..."
Quality: 2
At the start of each new hostile room, you have a 20% chance to gain a random charmed familiar which will fight for you
The charmed enemy has its own health bar and will die if it takes enough damage
Charmed enemies persist between each room and floor for as long as they stay alive
Allows you to have more than one charmed familiar at a time if you can keep them alive
Type: Passive
Item Pool: Shop
BackStabber
ItemID: 506
"Watch your back!"
Quality: 3
Every time one of your tears hits an enemy, it has a chance to start bleeding, which will cause it to take damage every 5 seconds
The bleed damage dealt by BackStabber is based on how quickly an enemy is moving (faster enemies take more damage)
Damaging enemies from behind gives the bleed effect a 100% chance to apply
While an enemy bleeds, they leave behind creep that damages other enemies
The tear that inflicts the bleed effect also deals double damage
The bleed effect cannot be applied to immune enemies (e.g. bosses and mini bosses)
Type: Passive
Item Pool: Item Room, Devil Room
Sharp Straw
ItemID: 507
"More blood!"
Quality: 2
When used, Sharp Straw will deal damage to all enemies in the room
The damage dealt is equal to Isaac's current tear damage plus 10% of the enemy's max health
Every time this item deals damage, it has a 15% chance to drop 1/2 red hearts
REPENTANCE - Sharp Straw is now only able to generate half red hearts (previously, it generated half soul hearts if the player had no heart containers)
Type: Active
Recharge Time: 8 seconds
Item Pool: Item Room
Mom's Razor
ItemID: 508
"It's sharp!"
Quality: 2
A razor blade orbital that deals contact damage and applies the bleeding status effect to enemies and bosses, which will cause them to take damage every 5 seconds
The contact damage dealt by Mom's Razor is based on how quickly an enemy is moving (faster enemies take more damage)
While an enemy bleeds, they leave behind creep that damages other enemies
This item DOES block enemy shots
Its speed is not affected by the Guardian Angel item
Counts as 1 of 3 mom items needed towards the Mom transformation
Type: Passive, Familiar
Item Pool: Item Room, Mom's Chest
Bloodshot Eye
ItemID: 509
"Bloody friend"
Quality: 1
An eye orbital that shoots tears that deal 3.5 damage and deals 2 contact damage per tick to enemies
The damage dealt by this orbital does not scale with damage upgrades
Its speed is not affected by the Guardian Angel item
REPENTANCE - Bloodshot Eye now blocks enemy shots, has increased shot speed and rate of fire, and now only shoots when lined up with enemies
Type: Passive, Familiar
Item Pool: Item Room
Delirious
ItemID: 510
"Unleash the power!"
Quality: 1
When used, spawns a charmed random white delirium version of a boss, that will fight for you and kill other enemies for the rest of the current room
Possible bosses spawned include most bosses in the game
Some bosses' effects can harm Isaac. For example if the spawned boss leaves creep, it can damage Isaac
Unlock this item by defeating Delirium for the first time on any character
Type: Active
Recharge Time: 12 rooms
Item Pool: Angel Room
Angry Fly
ItemID: 511
"He's violent"
Quality: 1
A familiar fly that orbits around a random enemy in the room until that enemy dies, dealing 2 contact damage to other enemies
Angry Fly will move to the next enemy after the one it is currently orbiting dies, until the room is cleared, at which point it will return to orbiting Isaac
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Custom Phase
Counts as 1 of 3 fly items needed towards the Beelzebub transformation
Unlock this item by transforming into Beelzebub (Achieved by picking up 3 fly related items, see Transformations page for full list)
Type: Passive, Familiar
Item Pool: Item Room
Black Hole
ItemID: 512
"Nothing can escape"
Quality: 1
A throwable active item that places a black hole on the ground where it lands, sucking all enemies into it for 6 seconds
Enemies stuck inside the black hole take rapid damage over time
The Black Hole will also suck Isaac into it, but with a much weaker effect than to enemies
The Black Hole will destroy nearby obstacles such as rocks and pots
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Custom Phase
Type: Active
Recharge Time: 4 rooms
Item Pool: Item Room
Bozo
ItemID: 513
"Party time!"
Quality: 2
+0.1 Damage Up
+1 Soul Heart
Adds a random chance for an enemy in the current room to become charmed or feared briefly
Adds a random chance to spawn a rainbow poop upon taking damage
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Electoon
Unlock this item by breaking 5 rainbow poops
Type: Passive
Item Pool: Item Room
Broken Modem
ItemID: 514
"LAG!"
Quality: 3
Causes random enemies to 'lag' at random intervals, causing them to freeze in place for a second
The lag effect can also apply to tears, projectiles and consumables on the ground
While held, this item has a 25% chance to double up any end of room drops (similar to the Contract from Below effect)
Isaac's Luck stat affects how often the lag effect occurs
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Freezenification
Complete 7 Daily Challenges (30 on console)
Type: Passive
Item Pool: Shop
Mystery Gift
ItemID: 515
"Wrapped up nice for you!"
Quality: 3
A one-time use item that spawns a random item from the current room's item pool, with a chance for it to spawn Lump of Coal or The Poop instead
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Mills
Type: Active
Recharge Time: One time use
Item Pool: Shop
Sprinkler
ItemID: 516
"Sprinkles."
Quality: 2
When used, spawns a Sprinkler that rotates in a circle, spraying tears in all directions
Will also synergize with some other items, such as Mom's Eye, Brimstone, Dr. Fetus, Tech X or Loki's Horns
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Kieran and Stewartisme
Type: Active
Recharge Time: 4 rooms
Item Pool: Item Room
Fast Bombs
ItemID: 517
"Faster Bomb Drops!"
Quality: 1
+7 Bombs
Allows you to rapidly place bombs on the ground
Added as part of the Afterbirth+ Booster Pack #1
REPENTANCE - Bombs no longer knock each other around when the player has Fast Bombs, allowing for a more controlled line of explosions.
Unlock this item by defeating Lil Horn 20 times
Type: Passive
Item Pool: Item Room
Buddy in a Box
ItemID: 518
"What could it be?!"
Quality: 2
When picked up, gives Isaac a random familiar which has a random sprite and tear effect
The familiar will be fully randomized again upon entering the next floor
The appearance is chosen from a random co-op baby sprite
Counts as 1 of 3 familiar items needed towards the Conjoined transformation.
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Ashkait and Scayze
Type: Passive, Familiar
Item Pool: Shop
Lil Delirium
ItemID: 519
"He's Delirious"
Quality: 2
A familiar that will transform into another random familiar every 10 seconds, copying their behaviour and effect
Can be any other familiar, including (but not limited to) Lil Brimstone, Bob's Brain, BBF, Meatboy, Rotten Baby
Familiars appear as a white Delirium version of the original
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Ashkait and Scayze
Type: Passive, Familiar
Item Pool: Angel Room, Devil Room
Jumper Cables
ItemID: 520
"Bloody recharge!"
Quality: 3
This item gives you 1 bar of charge on your active item for every 15 enemies you kill
Added as part of the Afterbirth+ Booster Pack #2 and based on the Steam Workshop mod created by Ashkait and Scayze
Unlock this item by picking up any 3 of these items in a single run: 9 Volt, The Battery, Car Battery, AAA Battery, Watch Battery
Type: Passive
Item Pool: Greed Mode Item Room, Shop
Coupon
ItemID: 521
"Allow 6 weeks for delivery"
Quality: 2
When used, the coupon causes one random item in the shop to become free
While held, guarantees a random item or pickup from the shop to be half price
The effect of this item also works in Devil Rooms, allowing you to take one random item for free
Added as part of the Afterbirth+ Booster Pack #2 and based on the Steam Workshop mod created by Plumbo
Type: Active
Recharge Time: 6 rooms
Item Pool: Item room, Shop, Beggar
Telekinesis
ItemID: 522
"The power of mind!"
Quality: 1
An active that causes all enemy tears to be held in place and then thrown back away from Isaac for a period of 3 seconds
The aura from this item will repel nearby enemies
Added as part of the Afterbirth+ Booster Pack #2
Type: Active
Recharge Time: 6 seconds
Item Pool: Item Room, Greed Mode Item Room
Moving Box
ItemID: 523
"Pack and unpack"
Quality: 1
When used, the box will pick up a maximum of 6 items. Using the box again will put the picked up items back on the floor again, allowing you to move things between rooms
Can move any of the following: Batteries, Items, Trinkets, Hearts, Keys, Bombs, Coins, Chests and more
Using Moving Box with Car Battery will trigger 2 interactions at the same time: First it will drop all items currently inside the box and secondly will then pick up the current room's contents
When used in a room with 2 items you can choose from (e.g. There's Options, Double item room, Boss Rush) the Moving Box will pick only one of the items at random
Added as part of the Afterbirth+ Booster Pack #2 and based on the Steam Workshop mod created by HurleyFarrill
Unlock this item by using Pandora's Box in the Dark Room floor
Type: Active
Recharge Time: 4 rooms
Item Pool: Shop
Technology Zero
ItemID: 524
"Static tears!"
Quality: 3
Your tears will now be connected together by beams of electricity which deals damage to enemies they hit
The lasers from this item deal 30% of your current damage stat
Added as part of the Afterbirth+ Booster Pack #2 and based on the Steam Workshop mod created by Ashkait and Scayze
REPENTANCE - Technology Zero's lasers now deal 30% of the player's damage stat per tick (from 100%)
Unlock this item by having 2 technology items at once
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Leprosy
ItemID: 525
"You're tearing me apart!"
Quality: 1
Taking damage will spawn an orbital that rotates around Isaac, dealing contact damage to enemies and blocking enemy projectiles
A maximum of 3 Leprocy orbitals can be active at one time
Using the orbital to deal damage to enemies can cause it to break
Added as part of the Afterbirth+ Booster Pack #2. Based loosely on the Steam Workshop mod created by Extreme Ninja Home Makeover with changes by Edmund McMillen
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
7 Seals
ItemID: 526
"Lil Harbingers!"
Quality: 2
Gives you a random Harbinger familiar that changes every 10 seconds
Each harbinger behaves differently, based on any of the original 5 horsemen bosses
REPENTANCE - The harbingers will also randomly spawn their relevant Locust variant. The locust fly will do different things for each harbinger - e.g. poison effect for Pestilence
Added as part of the Afterbirth+ Booster Pack #3. Based on the Steam Workshop mod created by by Scayze and Ashkait
Type: Passive
Item Pool: Devil Room, Angel Room
Mr. ME!
ItemID: 527
"Caaan Do!"
Quality: 3
Upon use, this item summons a ghost near Isaac that will follow him around. Also summons a blue crosshair which can be moved around freely. After a few seconds, the crosshair will disappear, and the Ghost will do certain things based on what you targeted:
Items, pickups, trinkets: Brings them to Isaac. Works in shops and devil deals as well, allowing you to take them for no cost. Stealing an item has a chance to fail (a buzzer sound will play if it fails)
Buttons: Presses the button
Enemies: Attacks the enemy until either the ghost or the enemy dies
Doors: Opens the door, even if it is locked
Secret room entrances: Explodes and opens the entrance
Boss rush door: Will open the Boss Rush door from either side, allowing you get into and escape the Boss Rush
Slot machines, dead shopkeepers: Charges towards them and explodes them
Added as part of the Afterbirth+ Booster Pack #3. Based on the Steam Workshop mod created by Jean-Alphonse
Unlock this item by opening 20 locked chests
Type: Active
Recharge Time: 4 rooms
Item Pool: Shop, Key Beggar
Angelic Prism
ItemID: 528
"Eclipsed by the moon"
Quality: 3
Grants a prism orbital with a large orbital radius
Isaac's tears that pass through the prism split into four multi-colored tears
Does not deal contact damage to enemies that it passes over
Added as part of the Afterbirth+ Booster Pack #3. Based on the Steam Workshop mod created by electoon and Erfly
Type: Passive, Orbital
Item Pool: Angel Room
Pop!
ItemID: 529
"Eyeball tears!"
Quality: 1
Replaces Isaac's tears with eyeballs that can bounce off of each other
Issac's tears are no longer limited by range, and will instead dissipate when they stop moving or when hitting an enemy or obstacle
Added as part of the Afterbirth+ Booster Pack #3. Based on the Steam Workshop mod created by Scayze and Ashkait
Type: Passive
Item Pool: Item Room
Death's List
ItemID: 530
"Just hope you're not next"
Quality: 2
Upon entering a room, a skull appears over a random enemy's head
Killing the marked enemy will cause the skull to move to a different enemy
If all enemies in the room are cleared in the order they are marked, Isaac gains a random reward from one of the following: Soul heart, Key, Pill, Bomb, Nickel, +0.2 Speed, +0.5 Range, +0.5 Tears, +1 Flat damage or +1 luck
Killing enemies in the wrong order will end the streak and deny you any extra rewards
Added as part of the Afterbirth+ Booster Pack #4. Based on the Steam Workshop mod created by Merlo
Type: Passive
Item Pool: Devil Room
Haemolacria
ItemID: 531
"I'm seeing red..."
Quality: 4
With Haemolacria, Isaac's tears become bloody and now fire by in the air in an arc
Upon hitting the floor, an obstacle or enemy, the bloody tear will burst and fire lots of smaller tears at random directions around the impact point
Tears Down - (Tear delay * 2) + 10
Your damage stat is unaffected by this item, however the large bloody tear does +31% of your tear damage and the smaller scattering tears deal 50-80% of your tear damage
Added as part of the Afterbirth+ Booster Pack #4. Based on the Steam Workshop mod (originally called Water Balloon) created by HiHowAreYou
Unlock this item by picking up the Blood Clot item 10 times
Type: Passive
Item Pool: Item Room
Lachryphagy
ItemID: 532
"Feed them!"
Quality: 2
Isaac's tears slow down over time while moving across the room, and upon stopping completely or hitting an object will burst into 8 smaller tears which fire in all directions
This item will also allow you to 'feed' a tear with other tears. Doing so will cause it to increase in size, and also increase their damage and the damage of the burst tears
Once a tear is fed 5 times, it will immediately burst
Tears in the burst will deal half the damage the main tear would have
Tears which hit an enemy do not burst
Added as part of the Afterbirth+ Booster Pack #4. Based on the Steam Workshop mod (originally called Hungry Tears) created by Echo
Unlock this item by taking 10 Tears Up items or pills in the same run
Type: Passive
Item Pool: Item Room
Trisagion
ItemID: 533
"Smite thy enemy"
Quality: 3
Isaac's tears are replaced with piercing holy flashes of light, which travel across the room in a similar speed to regular tears
Trisagion tears deal roughly 33% of your usual tear damage, however due to the size of the holy flash it is likely to hit enemies multiple times
Trisagion tears cause no knockback on enemies and simply travel through them (piercing tears)
Added as part of the Afterbirth+ Booster Pack #4. Based on the Steam Workshop mod (originally called Lightshot) created by Wyvern and TRPG
Unlock this item by taking 25 Angel Room items
Type: Passive
Item Pool: Angel Room
Schoolbag
ItemID: 534
"Extra active item room"
Quality: 3
Gives you an extra active item slot
Pressing the CTRL key (R2 on PS4, RT on XB1, ZR on Switch) allows you to switch active items
Some items that give temporary effects like The Nail might deactivate if switched to the other slot
Added as part of the Afterbirth+ Booster Pack #4
Unlock this item by entering every Shop from the first floor up to Mom's Foot (Depths 2) in one run
Type: Passive
Item Pool: Shop, Gold/Stone Chest
Blanket
ItemID: 535
"You feel safe"
Quality: 2
+1 Soul Heart
Heals 1 red heart when picked up
Grants you a shield when entering the Boss Room, which prevents damage from 1 hit, then disappears. This shield stacks with Holy Mantle, giving you 2 free hits
Added as part of the Afterbirth+ Booster Pack #5. Based on the Steam Workshop mod created by Ratlah
Unlock this item by sleeping in 10 different beds
Type: Passive
Item Pool: Shop
Sacrificial Altar
ItemID: 536
"He demands a sacrifice"
Quality: 2
When used, this item will sacrifice up to 2 of your familiars (chosen at random), and spawn a random Devil Room item for each familar sacrificed this way
In addition to the familiars, any blue flies or spiders will be converted to 1 coin each
If Guardian Angel, Sworn Protector, or Seraphim is sacrificed, Satan will be extra happy and reward you with 2 black hearts
Incubus won't be sacrificed if you're playing as Lilith
If used while you have no familiar, this item will do nothing and won't consume the item
Added as part of the Afterbirth+ Booster Pack #5. Based on the Steam Workshop mod created by Niro
Type: Active
Recharge Time: Single use
Item Pool: Devil Room, Curse Room
Lil Spewer
ItemID: 537
"Puking buddy"
Quality: 1
A familiar with a charged attack, that spawns a line of creep on the floor which damages enemies that walk over it
Spawns 1 random pill when picked up
The familiar and its creep will change randomly when Isaac uses a pill
Possible creep types include green (deals damage), black (slows enemies), red (deals damage, forms a line with a larger puddle), yellow (deals damage, forms a short-range cone) and white (slows enemies, forms a ring)
Added as part of the Afterbirth+ Booster Pack #5. Based on the Steam Workshop mod created by Strawrat and Aczom
Unlock this item by dying to your own Ipecac explosion
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Marbles
ItemID: 538
"Choking hazard"
Quality: 2
Spawns 3 random trinkets when picked up
Upon taking damage, you have a random chance to consume one of your currently held trinkets, gaining its effect permanently
Added as part of the Afterbirth+ Booster Pack #5. Based on the Steam Workshop mod created by Amethyst
Unlock this item by using 5 Gulp! pills in one run
Type: Passive
Item Pool: Boss Room
Mystery Egg
ItemID: 539
"Sacrificial insemination"
Quality: 1
A familiar which follows Isaac and, upon taking damage, will spawn a charmed enemy that will fight for you
When the charmed enemy is spawned the egg will crack, but regenerate in the next room
Added as part of the Afterbirth+ Booster Pack #5. Based on the Steam Workshop mod created by Strawrat and Aczom
Unlock this item by spawning 3 charmed enemies in a single room
Type: Passive
Item Pool: Item Room
Flat Stone
ItemID: 540
"Skipping tears"
Quality: 2
Flat Stone causes your tears to bounce across the room
Whenever a tear bounces, it deals splash damage to nearby enemies for 25% of your tear damage
Added as part of the Afterbirth+ Booster Pack #5. Based on the Steam Workshop mod created by Maddogs
Unlock this item by picking up Rubber Cement 5 times
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Marrow
ItemID: 541
"HP up?"
Quality: 1
+1 Bone Heart
Spawns 3 red hearts on the ground when picked up
Added as part of the Afterbirth+ Booster Pack #5
Unlock this item by defeating Mom's Heart on hard mode as The Forgotten
Type: Passive
Item Pool: Boss Room
Slipped Rib
ItemID: 542
"Projectile shield"
Quality: 2
This item gives you an orbital, which will reflect projectiles back at enemies
Unlike some other orbitals, Slipped Rib doesn't deal contact damage to enemies
Added as part of the Afterbirth+ Booster Pack #5
Unlock this item by defeating the Isaac boss as The Forgotten
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Hallowed Ground
ItemID: 543
"Portable sanctuary"
Quality: 1
A familiar which follows Isaac and spawns a white poop when you take damage
The white poop gives an aura that cuts your tear delay in half (Tears up) and has a chance to block damage
The aura disappears if the poop is destroyed
Added as part of the Afterbirth+ Booster Pack #5
Counts as 1 of 3 poop items needed towards the Oh Crap transformation.
Can cause white poops through other item effects such as A Card Against Humanity or Re-Lax pills.
REPENTANCE - White poop from Hallowed Ground is now more durable, similar to golden poop. While standing in the aura, Isaac's damage is now also increased by 25%, and his tears gain a homing effect
Unlock this item by defeating Hush as The Forgotten
Type: Passive
Item Pool: Item Room, Angel Room
Pointy Rib
ItemID: 544
"Stabbing time"
Quality: 2
A familiar that can be aimed with the fire buttons similar to the Finger item, dealing contact damage to enemies equal to your tear damage
Added as part of the Afterbirth+ Booster Pack #5
Unlock this item by defeating Satan as The Forgotten
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Book of the Dead
ItemID: 545
"Rise from the grave"
Quality: 3
When used, this item will spawn a bone orbital or charmed Bony for each enemy killed in the current room
The orbitals and charmed enemies persist when travelling between rooms
Bone orbitals break after dealing enough damage or blocking too many shots
Added as part of the Afterbirth+ Booster Pack #5
Counts as 1 of 3 book items needed towards the Bookworm transformation.
Unlock this item by defeating Delirium in The Void floor as The Forgotten
Type: Active
Recharge Time: 6 rooms
Item Pool: Item Room, Library, Devil Room
Dad's Ring
ItemID: 546
"Father's blessing"
Quality: 3
A passive item that puts a yellow ring around Isaac. Enemies are frozen in place while touching the yellow ring
Enemies touching the ring will stay permanently frozen until you move away, except for bosses which only get a temporary freeze effect after touching it
Added as part of the Afterbirth+ Booster Pack #5
Unlock this item by defeating Ultra Greedier as The Forgotten
Type: Passive
Item Pool: Secret Room
Divorce Papers
ItemID: 547
"Tears up + you feel empty"
Quality: 3
+1 Bone Heart
+0.7 Tears Up
When you pick this item up, the Mysterious Paper trinket is spawned on the ground
Added as part of the Afterbirth+ Booster Pack #5
Unlock this item by defeating Boss Rush as The Forgotten
Type: Passive
Item Pool: Boss Room
Jaw Bone
ItemID: 548
"Fetch"
Quality: 1
A familiar that flies across the room every few seconds while firing and damages enemies (2x your tear damage)
Can also be used like the Boomerang to pick up consumables on the ground
Added as part of the Afterbirth+ Booster Pack #5
Unlock this item by defeating ??? in The Chest floor as The Forgotten
Type: Passive
Item Pool: Item Room, Greed Mode item Room
Brittle Bones
ItemID: 549
"Everything hurts"
Quality: 3
When picked up, this item replaces all of your red heart containers with 6 Bone Hearts
Every time you lose a bone heart, lots of bones fire in all directions damaging any enemies hit and you gain a permanent +0.5 Tears Up
For the Lost and Keeper characters, this item simply gives a permanent Tears Up
Added as part of the Afterbirth+ Booster Pack #5
Unlock this item by defeating The Lamb in the Dark Room floor as The Forgotten
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
Broken Shovel
ItemID: 550
"It feels cursed"
Quality: 4
Obtained by beating the Basement 1 boss within 1 minute, then bombing the large shadow that appears in the middle of the starting room
While held, Mom's Foot will stomp on you from above twice every few seconds, and she will continue to stomp for as long as you hold this item
Using the Broken Shovel will stop Mom stomping you for the rest of the current room (or current wave if you're in the boss rush or challenge room)
Beating the Boss Rush while holding this item will drop the second half of the Broken Shovel, which combine to create Mom's Shovel, which is used to unlock The Forgotten character
Dropping the Broken Shovel will cause it to disappear if you leave the room
NOTE: This item will not drop unless you have beaten The Lamb at least once
Added as part of the Afterbirth+ Booster Pack #5 and used in the quest to unlock The Forgotten character
Type: Active
Recharge Time: 4 rooms
Broken Shovel
ItemID: 551
"Lost but not forgotten"
Quality: 4
Drops after beating the Boss Rush while holding the other half of the Broken Shovel (see previous item for more details)
Combines with the first Broken Shovel piece to create Mom's Shovel (see next item for more details)
Added as part of the Afterbirth+ Booster Pack #5 and used in the quest to unlock The Forgotten character
Type: Passive
Mom's Shovel
ItemID: 552
"Lost but not forgotten"
Quality: 4
When used, spawns a trapdoor that leads to the next floor
Digging in certain spots with objects or markings on the floor will guarantee a crawlspace once per floor
Unlocks The Forgotten character when used on a mound of dirt that appears in a room in The Dark Room floor
Obtained by combining the two Broken Shovel pieces. The first piece drops by beating the first floor boss within 1 minute then bombing the shadow in the first room. The second piece drops after beating the Boss Rush as long as you are holding the first Broken Shovel piece (see previous 2 items for full details)
After The Forgotten is unlocked, using it on the mound of dirt again just spawns a random type of chest
Added as part of the Afterbirth+ Booster Pack #5 and used in the quest to unlock The Forgotten character
Type: Active
Recharge Time: 4 rooms
Rebirth Trinkets (60)
Swallowed Penny
TrinketID: 1
"Gulp!"
Each time you get hit, you drop a coin or two
Unlock this item by beating Challenge #15 (Slow Roll)
Petrified Poop
TrinketID: 2
"It feels lucky?"
While held, Isaac has a significantly higher chance to find drops when breaking poops
AAA Battery
TrinketID: 3
"Trickle charge"
Lowers your spacebar item charge rate by 1
Cannot lower the charge of your spacebar item below 1 room
For example, you will now be able to use a 3 room charge item after 2 rooms instead
Broken Remote
TrinketID: 4
"It's broken"
Does the teleport effect every time you use your current spacebar item
Can be used infinitely every room if you have Guppy's Paw and no red heart containers (Can be exploited to get to the boss room without clearing any other rooms)
Purple Heart
TrinketID: 5
"Challenge up"
Higher chance for champion enemies while held
Broken Magnet
TrinketID: 6
"It kinda works"
Has a partial Magneto effect and will attract coins, pulling them into Isaac from a distance
Does not attract other pickups like the full Magneto item does
Rosary Bead
TrinketID: 7
"Faith up"
Increases your chances to find an Angel Room instead of a Devil Room
Normally there is a 50%/50% chance of a Angel or Devil room with if a door spawns after the boss. The Rosary Bead changes this to a 75%/25% chance of an angel or devil room (respectively)
Cartridge
TrinketID: 8
"I remember these"
When Isaac takes damage, there is a chance he will gain the Gamekid effect, turning him invincible and dealing contact damage to any enemies he touches
The chance to activate the invincibility effect is affected by your luck stat and at +38 Luck it will activate every time you get hit
Pulse Worm
TrinketID: 9
"Wub wub!"
Tears shrink and grow in size as they go across the room
Does not appear to affect your damage and only the hitbox size of tears
Wiggle Worm
TrinketID: 10
"Wiggle wiggle!"
Tears now move in a wave fashion across the room
Grants spectral tears
+0.4 Tears up
Ring Worm
TrinketID: 11
"Woop woop!"
While held, tears move in a spiral pattern across the screen at high speed
Grants spectral tears
+0.4 Tears up
Effectively increases your range due to the tear pattern
Flat Worm
TrinketID: 12
"Blub blub!"
Tears become flat and disc shaped giving them a larger hitbox
Higher knockback effect with your tears
Store Credit
TrinketID: 13
"YES!"
While this trinket is held, all items in the Shop cost 0 coins
After buying any 0 cent item in the Shop, the trinket disappears
Unlock this item by beating the Chest with Lazarus
Callus
TrinketID: 14
"Your feet feel stronger"
Isaac no longer takes damage from walking over spikes and blood creep while this trinket is held
Lucky Rock
TrinketID: 15
"There's something inside"
33% chance to drop a coin for every rock that you destroy
Unlock this item by destroying 100 rocks
Mom's Toenail
TrinketID: 16
"???"
Mom's Leg will now appear every 20 seconds and stomp down randomly in the room dealing 300 damage to enemies
Be warned though, Mom's leg can also stomp and hurt Isaac too!
Black Lipstick
TrinketID: 17
"Evil up"
Increases the chance for Black hearts to spawn
Unlock this item by beating the Dark Room with Eve
Bible Tract
TrinketID: 18
"Faith up"
Gives you a higher chance of eternal hearts
Contrary to popular belief, the Bible Tract doesn't allow Angel Rooms to appear after paying for a Devil Deal
Paper Clip
TrinketID: 19
"Master of lockpicking"
Allows you to unlock golden chests without needing a key
Does not work on locked rooms
Cain starts with this trinket after donating 68 coins to the Greed Donation Machine
Monkey Paw
TrinketID: 20
"Wish granted"
When you reach half a heart of life remaining, a black heart will spawn
After three black hearts have spawned, the trinket dissapears
Mysterious Paper
TrinketID: 21
"???"
Imitates the behaviours of some of the other 'paper' items/trinkets
A Missing Page: When taking damage, Isaac has a chance to deal damage to the entire room in a Necronomicon style effect
Has a chance to trigger the Polaroid or Negative effect every time you take damage with half a red heart or less
Missing Poster: Dying in a sacrifice room while holding this trinket will reveal a puzzle piece on the death screen. Finding all the puzzle pieces will help you to reveal the final secret, unlocking the hidden character 'The Lost'
If held when you touch the chest after the Satan or Isaac fight and you don't have the relevant item to go to the next floor (Polaroid or Negative), you have a small chance to be taken there anyway
Unlock this item by beating the Chest with Eden
Daemon's Tail
TrinketID: 22
"Evil up"
80% of heart drops are replaced with keys
Hearts turn into black hearts where possible. This doesn't convert hearts that dropped before picking up this trinket, and doesn't apply to set heart drops, i.e. the eternal hearts that drop in angel themed super secret rooms
All heart drops from Ace of Hearts will be Black Hearts
Unlock this item by beating Satan with Azazel
Missing Poster
TrinketID: 23
"???"
Dying in a sacrifice room while holding this trinket will unlock The Lost character
After The Lost is unlocked, dying anywhere with this trinket will bring you back to life as The Lost and the trinket will be deleted
When playing as Tainted Lost, you don't swap to being regular Lost, it simply acts as an extra life
Unlock this item by beating Dark Room with Isaac
Butt Penny
TrinketID: 24
"Wealth of gas"
Everytime you pick up a coin, you fart, inflicting poison damage to nearby enemies
Greatly increases the chance of coins dropping from poops
Mysterious Candy
TrinketID: 25
"Uh-oh!"
Causes Isaac to create poops randomly
Hook Worm
TrinketID: 26
"Zip zoop!"
Tears now move forwards at right angles, shifting left and right across the room
+0.4 Tears up
Grants spectral tears
Increases your range stat by +10.0 while held but due to the fire pattern, your tears travel a similar distance to normal
Whip Worm
TrinketID: 27
"Wooosh!"
+0.5 Shot Speed Up
Your tears now whip across the room at a very high shot speed
Shot speed gives your tears more effective range, but doesn't increase your range stat directly
Broken Ankh
TrinketID: 28
"Eternal life?"
Has a 22.22% chance to respawn with 3 Soul hearts as Blue Baby when you die
Unlock this item by beating Satan with Lazarus
Fish Head
TrinketID: 29
"It stinks"
Everytime Isaac takes damage, one blue fly will spawn
Pinky Eye
TrinketID: 30
"Poison shots"
Isaac's tears have a chance to poison enemies
The poison effect leaves a damage over time, which deals 4 or 6 damage per tick
The chance to poison enemies is affected by your luck stat and at +18 Luck it will activate every time
Push Pin
TrinketID: 31
"Piercing shots"
Isaac now has a chance to make a spectral and piercing tear
The chance to fire a piercing tear is affected by your luck stat and at +18 Luck it will activate every time
Liberty Cap
TrinketID: 32
"Touch fuzzy, get dizzy!"
While held, this trinket gives a random mushroom effect each room
Possible mushrooms include: Mini Mush, Odd Mushroom (Thin), Odd Mushroom (Thick), The Compass
Umbilical Cord
TrinketID: 33
"Fetal protection"
While at 1/2 a red heart of health, you gain a Little Steve familiar that follows you and shoots homing tears
Umbilical Cord has a high chance to spawn a Gemini familiar for the room when Isaac takes damage. This effect is stackable
Child's Heart
TrinketID: 34
"It calls out to its brothers"
Gives Isaac a higher chance to find hearts from drops after clearing a room and from chests
Curved Horn
TrinketID: 35
"DMG up"
+2 Damage Up
Unlock this item by beating the Dark Room with Judas
Rusted Key
TrinketID: 36
"It feels lucky?"
Gives Isaac a higher chance to find keys and chests
Goat Hoof
TrinketID: 37
"Speed up"
+0.15 Speed Up
Mom's Pearl
TrinketID: 38
"It emanates purity"
Grants a secondary chance of any non-specific heart drop turning into a soul heart
Cancer
TrinketID: 39
"Yay, cancer!"
-2 Tear Delay (Tears Up)
The fire rate increase is applied in such a way that the higher your tear stat is, the more effective Cancer is
Breaks the normal fire rate cap, allowing you to fire faster than the normal maximum
Red Patch
TrinketID: 40
"Your rage grows"
You have a chance when taking damage to gain +1.8 Damage Up for the rest of the room
Match Stick
TrinketID: 41
"Tastes like burning"
Gives Isaac a higher chance to find bombs
Picking up the Match Stick is the only way to remove the Tick trinket
Lucky Toe
TrinketID: 42
"Luck up!"
+1 Luck Up while held
Unlock this item by blowing up 20 shop keepers (this includes the ones in the secret room)
Cursed Skull
TrinketID: 43
"Cursed?"
When you take damage while on 1/2 a heart, you are teleported back to the previous room
Safety Cap
TrinketID: 44
"Don't swallow it"
Gives Isaac a higher chance to find pills
Ace of Spades
TrinketID: 45
"Luck of the draw"
Gives Isaac a higher chance to find Tarot cards after clearing a room or from chests
Isaac's Fork
TrinketID: 46
"Consume thy enemy"
After clearing a room, you have a chance to heal for half a red heart
A Missing Page
TrinketID: 48
"It glows with power"
When taking damage, Isaac has a chance to deal damage to the entire room in a Necronomicon style effect
The chance to damage enemies is affected by your luck stat and at +50 or more Luck it will activate 50% of the time
Bloody Penny
TrinketID: 49
"Wealth of health"
Everytime you pick up a penny, you have a 25% chance to spawn a red heart on the floor
Unlock this item by beating the Chest with Samson
Burnt Penny
TrinketID: 50
"Wealth of chaos"
Everytime you pick up a coin, you have a 25% chance to spawn a bomb on the floor
Unlock this item by beating Challenge #13 (Beans!)
Flat Penny
TrinketID: 51
"Wealth of answers"
Everytime you pick up a coin, you have a 25% chance to spawn a key
Counterfeit Penny
TrinketID: 52
"Wealth of wealth"
When picking up a coin, you have a chance to automatically gain one more coin
Unlock this item by playing the shell game in the arcade 100 times
Tick
TrinketID: 53
"Well, that's not coming off"
When you enter a boss room, immediately remove 15% health from the boss and restore 1 red heart
This trinket cannot be dropped by holding the drop key or picking up other trinkets. The only way to remove it is via having a second trinket slot (Mom's Purse, Belly Button) or absorbing it (Marbles, Smelter, Gulp! pill) or picking up the Match Stick trinket, which will burn it off you
Isaac's Head
TrinketID: 54
"Dead friend"
While held, this trinket gives Isaac a familiar that shoots piercing tears that deal 3.5 damage
Unlock this item by beating the Boss Rush with Isaac
Maggy's Faith
TrinketID: 55
"Faith's reward"
At the start of a new floor, you get an eternal heart
Unlock this item by beating the Dark Room with Maggy
Judas' Tongue
TrinketID: 56
"Payment received"
Items which cost 2 heart containers in a deal with the devil are reduced to only cost 1 heart
Unlock this item by beating Satan with Judas
???'s Soul
TrinketID: 57
"Imaginary friend"
Creates a familiar which moves around the room in a similar fashion to The Peeper, shooting tears in the same direction as Isaac
Unlock this item by beating the Dark Room with Blue Baby
Samson's Lock
TrinketID: 58
"Your rage grows"
When you kill an enemy, you have a chance to get +0.5 damage up for the current room
Unlock this item by beating the Dark Room with Samson
Cain's Eye
TrinketID: 59
"May you see your destination"
Gives a 25% chance to reveal map icons at the start of a new floor (The same effect as the Compass)
Unlock this item by beating the Chest with Cain
Eve's Bird Foot
TrinketID: 60
"Revenge from beyond"
When you kill an enemy, you have a chance to spawn a transparent Dead Bird familiar
The Dead Bird familiar deals 2 damage per tick to enemies while in contact with them
Unlock this item by beating the Isaac boss with Eve
The Left Hand
TrinketID: 61
"The left hand path reaps dark rewards"
Replaces chest spawns with red chests
Doesn't replace chests that have already spawned
Unlock this item by beating Ultra Pride
Afterbirth Trinkets (29)
Shiny Rock
TrinketID: 62
"It shines for it's brothers"
While held, tinted rocks and rocks with a crawlspace below them will flash white every 10 seconds
Safety Scissors
TrinketID: 63
"Fuse cutter"
Turns all troll bombs into bombs which you can pick up and use
Super Troll bombs turn into 1+1 free double bomb pickups
Rainbow Worm
TrinketID: 64
"Bleep bloop blop"
Gives your tears a random worm effect every few seconds
The possible tear effects include: Whip Worm, Ring Worm, Wiggle Worm, Flat Worm, Hook Worm, Pulse Worm, Tape Worm and Lazy Worm
Tape Worm
TrinketID: 65
"Floooooooooop!"
While held, Tape Worm doubles your range stat and halves your tear height stat
Lazy Worm
TrinketID: 66
"Pft"
-0.4 Shot Speed Down
Cracked Dice
TrinketID: 67
"You feel cursed... kinda."
Every time you get hit, you have a chance to activate the D6, D20, D8, D10 or D12 effect
Unlock this item by beating Greed Mode with ???
Super Magnet
TrinketID: 68
"It pulls"
While held this trinket causes all pickups and enemies to move slowly towards you
Will also attract the Mom's Foot and Ultra Greed door entities
Faded Polaroid
TrinketID: 69
"You feel faded"
Randomly Isaac will gain a camouflage for a few seconds and all enemies in the current room will have a confused status effect applied to them
This trinket can be used to open the door to Mausoleum in Depths II
Louse
TrinketID: 70
"Itchy, tasty..."
Gives a small chance to spawn a friendly attack spider while in a hostile room with enemies
Bob's Bladder
TrinketID: 71
"Creepy bombs"
Leaves a pool of green creep under all bombs you place, which damages enemies that walk over it
Watch Battery
TrinketID: 72
"Lil charge"
Gives a +6.66% chance of a getting a small battery after clearing a room
Gives a +2.0% chance for pickups to be small batteries
Gives a +5.0% chance to add an extra charge to your active item after clearing a room
Blasting Cap
TrinketID: 73
"Pop! Pop!"
Exploding bombs now have a chance to drop another bomb that you can pick up
Stud Finder
TrinketID: 74
"The ground below feels hollow..."
Higher chance to find crawl spaces when exploding rocks
Unlock this trinket by beating Challenge #27 (Brains)
Error
TrinketID: 75
"Effect not found?"
Gives a different trinket effect per room, randomly choosing between any of the other available trinkets in the game
Each room is locked to a specific trinket effect, meaning if you exit and re-enter a room, that specific room will always have the same effect
Poker Chip
TrinketID: 76
"It's double down time!"
Chests now have a 50/50 chance to either pay out with extra consumables or nothing/an enemy
Unlock this trinket by beating Challenge #26 (I Rule)
Blister
TrinketID: 77
"Bounce back!"
Tears have a stronger knockback effect while this trinket is held
Second Hand
TrinketID: 78
"Extended stat effect time"
Increases the time that status effects stay on enemies. e.g. With poison effects, the damage over time poison will last for much longer
Endless Nameless
TrinketID: 79
"I'm stuck in a loop..."
While held there is a small chance when using a tarot card or pill that a copy of it will be dropped on the floor next to you
Black Feather
TrinketID: 80
"With darkness comes power"
+0.2 Damage Up for each 'evil' item you have
Items classed as evil in this case are Black Candle, Ceremonial Robes, Abaddon, Goat Head, Match Book, Missing Page 2, Safety Pin
Unlock this item by beating Greed Mode with Eve
Blind Rage
TrinketID: 81
"Blind to damage"
Invincibility lasts longer after getting hit (Increased i-frames)
This makes it possible to use the Blood Donation machine twice from one hit of damage
Unlock this item by beating Blue Womb (Hush) with Samson
Golden Horse Shoe
TrinketID: 82
"Feel lucky?"
+15% chance to get a double item room to spawn on the next floor
If the effect activates, two items spawn in your item room, however only one can be taken (Same effect as the More Options item)
The chance doubles to +30% with the effect from Mom's Box
Store Key
TrinketID: 83
"Stores are open"
Automatically opens all shop room doors for free
Unlock this trinket by donating 666 coins to the Greed Donation Machine
Rib of Greed
TrinketID: 84
"Feels greedy"
Forces the Greed and Super Greed mini bosses to no longer appear in shops or secret rooms
Holding Rib of Greed increase your chance to receive coin drops
Unlock this trinket by beating Ultra Greed with Keeper
Karma
TrinketID: 85
"Karma up"
Donating to a Donation Machine has a chance to heal Isaac for a full red heart or spawn a Beggar
Can't spawn in greed mode
Unlock this item by beating The Lamb boss with Keeper
Lil Larva
TrinketID: 86
"the poop is moving..."
Destroying poops now gives you a blue fly
Mom's Locket
TrinketID: 87
"you feel her love"
While held, you heal for half a red heart every time you use a key to open a door or golden chest
Changes all half red hearts into full hearts
Hearts dropped from Tainted Magdalene's mechanic will be always full red hearts
NO!
TrinketID: 88
"Never again!"
While this trinket is held you have a significantly lower chance to find spacebar/active items
It will cause passive items to spawn except when the game cannot generate any more passive items and will then instead choose spacebar/active items
Some hard coded spacebar items from bosses and mini-bosses (i.e. Krampus Head) can still spawn
Bible drops caused by the Rosary item are not prevented by this trinket
Child Leash
TrinketID: 89
"Keep your friends close..."
Causes your familiars to stay closer to each other
Brown Cap
TrinketID: 90
"Fartoom!"
Poop in the environment will now explode when destroyed
Afterbirth Plus Trinkets (38)
Meconium
TrinketID: 91
"Eww"
While held you have an increased chance for Black Poops to spawn, which deal damage to all enemies in the room when destroyed
Gives The Poop active item a chance to spawn a Black Poop too
Unlock this trinket by defeating Greedier Mode with ???
Cracked Crown
TrinketID: 92
"Boost Stats"
Boosts speed, range, shot speed, tears and damage if they are above their base values by roughly +20%
Affects stat bonuses from passive items, trinkets that are absorbed or in a second trinket slot, and permanent bonuses given by items such as Void
Unlock this trinket by getting a 5-win streak in daily challenges (must have a score of above 0 on the score screen)
Used Diaper
TrinketID: 93
"You Stink"
While held, gives the Skatole effect only in certain rooms, which will turn hostile flies to neutral and stop others from shooting
Attack, Dart and Ring Flies turn into neutral Black Flies and Pooters and Fat Flies will no longer fire at you
Fish Tail
TrinketID: 94
"It also stinks!"
Items and trinkets which generate blue flies and spiders will have double the effect, causing twice as many to spawn
Black Tooth
TrinketID: 95
"It looks dead"
Some tears will randomly become a black tooth, that deal double your normal tear damage and can poison enemies
Ouroboros Worm
TrinketID: 96
"Foop foop!"
Tears become spectral and travel in a huge spiral pattern
+1.5 Range Up
+0.4 Tears up
Tonsil
TrinketID: 97
"Sick..."
Every time you take damage you have a very small chance to gain a Tonsil familiar, which follows you and blocks enemy projectiles
This effect can happen twice before the Tonsil trinket is destroyed
Does not deal contact damage to enemies
Nose Goblin
TrinketID: 98
"Seems magic..."
Your tears have a random chance to become booger tears
Booger tears stick on to enemies and deal periodic poison damage until they die or 60 seconds passes. Each tick of poison damage is equal to your normal tear damage
The boogers will have a homing effect
Super Ball
TrinketID: 99
"Boing!"
Some random tears will gain the Rubber Cement effect and become bouncy
Vibrant Bulb
TrinketID: 100
"It needs power"
Grants +0.25 Speed, +0.75 Range, +0.1 Shot Speed, +0.2 Tears, +0.5 Damage and +1 Luck when Isaac's active item is fully charged
Infinite use items such as Potato Peeler count as charged and provide the bonus from this trinket
Dim Bulb
TrinketID: 101
"I think it's broken"
Grants +0.5 Speed, +1.5 Range, +0.3 Shot Speed, +0.4 Tears, +1.5 Damage when Isaac's active item is completely uncharged
One-time use items such as Mama Mega count as uncharged and provide the bonus from this trinket
Fragmented Card
TrinketID: 102
"Double moon"
Gives you another secret room on each new floor while held
Does not spawn more than one super secret room, only the normal secret room
Equality!
TrinketID: 103
"="
When you have the same amount of coins, bombs and keys, half consumables turn into their doubled version
This effect works for any number of consumables, including 0 and 99, as long as the count for coins/keys/bombs is equal
Wish Bone
TrinketID: 104
"Make a wish"
Every time you take damage you have a very small chance to spawn a random pedestal item
When the effect triggers, the trinket is destroyed
Bag Lunch
TrinketID: 105
"I wonder what it is"
Every time you take damage you have a very small chance to spawn the Lunch item, which gives +1 HP up
When the effect triggers, this trinket is destroyed
Lost Cork
TrinketID: 106
"Uncorked"
Increases the radius of any creep you produce
Crow Heart
TrinketID: 107
"Drain me"
While held, any damage taken remove red hearts first, before soul hearts, black hearts and rotten heart damage
While at 1/2 of a red heart, it will begin to remove your other hearts again
Unlock this item by beating Greedier mode with Eve
Walnut
TrinketID: 108
"Thats a hard nut to crack!"
The Walnut has a chance to break when taking damage from an explosion. If it does, it will drop a random trinket, coin, heart and key
The Walnut trinket is destroyed once the effect activates
Duct Tape
TrinketID: 109
"Stuck!"
Causes any orbitals you have to stop moving while held
Stops shooting familiars from moving (including Lilith's Incubus)
Some familiars with irregular movement are not affected by Duct Tape, such as Abel, BBF, Bumbo, Guppy's Hair Ball, Lil Gurdy, Punching Bag, Robo-Baby 2.0, Succubus
Silver Dollar
TrinketID: 110
"Feels lucky..."
While held, shops will now appear on the womb floors (The Womb, Utero and Scarred Womb)
Unlock this item by defeating Delirium in The Void floor with Cain
Bloody Crown
TrinketID: 111
"Drips with blood..."
While held, item rooms now appear on the womb floors (The Womb, Utero and Scarred Womb)
Causes item rooms to appear on the Corpse floors
Unlock this item by defeating Delirium in The Void floor with Samson
Pay To Win
TrinketID: 112
"..."
While held, restock boxes will always spawn in item rooms
Locust of War
TrinketID: 113
"I Bring Wrath"
Upon entering a room with enemies, spawns a Red Locust which detonates upon impact with enemies, dealing double tear damage for the impact of the Locust and 60 damage for the explosion
Can be dangerous as the fly will target the nearest enemy, which can be close enough to catch Isaac in its blast radius
Unlock this trinket by defeating Isaac in the Cathedral as Apollyon
Locust of Pestilence
TrinketID: 114
"I Bring Pestilence"
At the start of each new hostile room you spawn a green attack fly, which will target a nearby enemy, deal double your tear damage and then poison them
Unlock this item by beating Satan with Apollyon
Locust of Famine
TrinketID: 115
"I bring Famine"
At the start of each new hostile room you spawn a yellow attack fly, which will target a nearby enemy, deal double your tear damage and apply a slowing effect to it
Unlock this trinket by defeating ??? in The Chest as Apollyon
Locust of Death
TrinketID: 116
"I bring Death"
Upon entering a room with enemies, spawns a Black Locust that deals quadruple Isaac's damage, applied as two hits of double damage
Unlock this trinket by defeating The Lamb as Apollyon
Locust of Conquest
TrinketID: 117
"I Bring Conquest"
At the start of each new hostile room you spawn 2-5 white attack flies, which will target a nearby enemy and deal double your tear damage to it
Unlock this trinket by defeating Boss Rush as Apollyon
Bat Wing
TrinketID: 118
"They Are Growing..."
When killing an enemy, you have a very small chance to gain the ability to fly for the rest of the room
Unlock this trinket by defeating Greedier Mode with Azazel
Stem Cell
TrinketID: 119
"Regen!"
Stem Cell heals Isaac's red heart containers to 50% each floor
If Isaac already has 50% health or more, it heals half of a heart instead
Unlock this trinket by defeating Greedier Mode with Samson
Hairpin
TrinketID: 120
"Danger charge"
Fully recharges your active item at the start of each boss fight
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Zaratus
Wooden Cross
TrinketID: 121
"My faith protects me"
Gives you the Holy Mantle shield effect at the start of every new floor, which protects you from the next hit of damage you take
Does not recharge until the start of the next floor
Stacks with the effects from Holy Mantle and Blanket, but it does not stack with Holy Card
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Ep and Mills
Butter!
TrinketID: 122
"Can't hold it!"
Using your active item while holding this trinket will drop it back on a pedestal on the ground
Also after taking damage, you have a very small chance to drop one of your passive items
One-time use active items will be consumed and not dropped
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by MarkusLeben and iguesti
Filigree Feather
TrinketID: 123
"Angelic spoils!"
Holding this trinket will cause the Angel mini bosses to drop normal items instead of Key Pieces
Added as part of the Afterbirth+ Booster Pack #2, designed by Edmund McMillen
Door Stop
TrinketID: 124
"Hold the door!"
While held, the last door Isaac went through stays open, allowing him to leave the room even if enemies are in it
This trinket works on boss rooms (except Ultra Greed) and devil rooms containing Krampus, allowing you to exit out mid-fight
Does not drop in Greed mode
Unlock this trinket by blowing up doors and secret room walls 50 times
Extension Cord
TrinketID: 125
"Charged friends"
After being picked up, a yellow laser chain now flows through Isaac's familiars
Added as part of the Afterbirth+ Booster Pack #4 and based on the Steam Workshop mod created by Strawrat and Aczom
Rotten Penny
TrinketID: 126
"Wealth of flies"
While held, spawns +1 friendly blue fly every time you pick up a coin
Added as part of the Afterbirth+ Booster Pack #5. Based on the Steam Workshop mod created by Eufuu
Unlock this trinket by having a lot of blue flies at once
Baby-Bender
TrinketID: 127
"Feed them magic!"
While held this trinket gives your familiars homing shots
Added as part of the Afterbirth+ Booster Pack #5. Based on the Steam Workshop mod created by Ink Tears
Unlock this item by having two items or effects that grant homing shots at once (e.g. Spoon Bender, Telepathy for Dummies, I - The Magician)
Finger Bone
TrinketID: 128
"It looks brittle"
While held, gives you a 5% chance to gain a bone heart everytime you take damage
Added as part of the Afterbirth+ Booster Pack #5
Unlock this trinket by defeating Ultra Greed as The Forgotten
Consumables + Misc.
O - The Fool
CardID: 1
"Where your journey begins"
Teleports the player to the first room of the current floor
There is a guaranteed Fool card in the Depths 2, if you bomb the skull with an X on it. This is intended give you a guaranteed way to teleport out of the Mom's Foot fight, for accessing the path to the Mausoleum floor
I - The Magician
CardID: 2
"May you never miss your goal"
For the current room, tears now have the Spoon Bender effect, which allows them to curve towards enemies and gives them a purple appearance.
II - The High Priestess
CardID: 3
"Mother is watching you"
Summons Mom's foot which will stomp on a random enemy in the current room, dealing 300 damage
If no enemies are in the current room, the foot will target Isaac (and do damage if it hits), however it can be used to break rocks
III - The Empress
CardID: 4
"May your rage bring power"
Gives the player the Whore of Babylon effect for the current room, increasing damage and speed
IV - The Emperor
CardID: 5
"Challenge me!"
Teleports the player to the Boss room on the current floor
V - The Hierophant
CardID: 6
"Two prayers for the lost"
Spawns 2 Soul hearts on the floor
VI - The Lovers
CardID: 7
"May you prosper and be in good health"
Spawns 2 red hearts on the floor
If used in a Super Secret Room containing a Black Heart or Eternal Heart, it will spawn those types of hearts instead
VII - The Chariot
CardID: 8
"May nothing stand before you"
Grants the same effect as 'My Little Unicorn', which makes Isaac invincible and deal 40 contact damage to enemies per hit
VIII - Justice
CardID: 9
"May your future become balanced"
Spawns 1 bomb, 1 key, 1 coin, 1 heart, which can be random variants of each
IX - The Hermit
CardID: 10
"May you see what life has to offer"
Teleports the player to the Shop
On or below the Womb, this acts as a random teleport, since there are no shops on those floors
X - Wheel of Fortune
CardID: 11
"Spin the wheel of destiny"
Spawns a Slot Machine or a Fortune Machine
XI - Strength
CardID: 12
"May your power bring rage"
Gives the player the Magic Mushroom effect, which increasing size and all stats by 1 for the current room
If you use the Strength card with 12 heart containers, it will take you down to 11 when you leave the room
XII - The Hanged Man
CardID: 13
"May you find enlightenment"
Gives the player the flying effect for the current room, allowing the player to fly over obstacles in the room
This card is useless if you have any item which allows you to permanently fly
XIII - Death
CardID: 14
"Lay waste to all that oppose you"
Deals 40 damage to all enemies in the room in a similar style to the Necronomicon
XIV - Temperance
CardID: 15
"May you be pure in heart"
Spawns a Blood Donation Machine
XV - The Devil
CardID: 16
"Revel in the power of your darkness"
Gives the Book of Belial effect for the current room, increasing damage
XVI - The Tower
CardID: 17
"Destruction brings creation"
Spawns some troll bombs at random locations in the current room
Each bomb deals 60 damage (normal bomb damage
XVII - The Stars
CardID: 18
"May you find what you desire"
Teleports the player to the Item Room
On or below the Womb, this acts as a random teleport, since there are no item rooms on those floors
XVIII - The Moon
CardID: 19
"May you find all you have lost"
Teleports the player to the Secret Room
XIX - The Sun
CardID: 20
"May the light heal and enlighten you"
A card with three uses: A full heal, deals 100 damage to all enemies in the current room and reveals the entire map for the current floor (Treasure Map + The Compass)
XX - Judgement
CardID: 21
"Judge lest ye be judged"
Spawns a beggar
Has a chance to be a demon beggar
Killing a Devil Beggar, Key Master, or Shell Game Beggar gives you an increased chance of finding Angel rooms instead of Devil rooms. See the dedicated Devil room page for more details
XXI - The World
CardID: 22
"Open your eyes and see"
Reveals the entire map and shows the icons for every room which has one
This is completely useless if you currently have both the Treasure Map and The Compass
2 of Clubs
CardID: 23
"Item multiplier"
Doubles the number of Bombs you have
If you have no bombs, it gives you two
2 of Diamonds
CardID: 24
"Item multiplier"
Doubles the number of coins you have
If you have no coins, it gives you two
2 of Spades
CardID: 25
"Item multiplier"
Doubles the number of keys you have
If you have no keys, it gives you two
2 of Hearts
CardID: 26
"Item multiplier"
Doubles your current red hearts up to full health
This card is useless for the BluŠµ Baby
Ace of Clubs
CardID: 27
"Convert all"
When used, turns all pickups, chests and non-boss enemies in the room into Bombs
Unlock this item by getting a 3 win streak
Ace of Diamonds
CardID: 28
"Convert all"
When used, turns all pickups, chests and non-boss enemies in the room into Coins
Unlock this item by defeating The Lamb in under 20 minutes
Ace of Spades
CardID: 29
"Convert all"
When used, turns all pickups, chests and non-boss enemies in the room into Keys
Unlock this item by defeating The Lamb without taking hearts, coins and bombs
Ace of Hearts
CardID: 30
"Convert all"
When used, turns all pickups, chests and non-boss enemies in the room into Hearts
Unlock this item by defeating any floor after Basement I with only half a heart of health (works as The Lost)
The Joker
CardID: 31
"???"
Teleports you to the Devil Deal Room on the current floor
Suicide King
CardID: 46
"A true ending?"
When used, instantly kills you and spawns 10 pickup on the floor
Each of the 10 things spawned can be any type of consumable or sometimes a pedestal item (up to a maximum of 3 pedestal items)
Any pedestal item created by Suicide King will be related to the room where it was used, meaning that using it in the Angel room will spawn Angel room items
Unlock this card by beating Challenge #7 (Suicide King)
Queen of Hearts
CardID: 79
"<3"
Drops 1-20 full red hearts on the floor
Unlock this card by defeating Mega Satan as Tainted Magdalene
Chaos Card
CardID: 42
"???"
A card which can be thrown as a projectile directly infront of Isaac, instantly killing anything it hits, including most bosses
If thrown at a multi-phase boss with multiple forms such Satan, Mega Satan or Hush it will only kill that particular phase of the boss
If thrown at a multi-phase boss that works from a single health bar such as Isaac, ??? or The Lamb, it will die instantly
Will not kill Delirium or The Beast
Will destroy rocks and poop in its path
Can also be thrown against a door to open it (Doesn't work against Mega Satan's door)
Throwing this at the Great Gideon boss will trigger a special animation and reveal a crawl space containing several chests and items!
Unlock this card by beating Challenge #9 (Demo Man)
Huge Growth
CardID: 52
"Become immense!"
Temporarily makes Isaac huge, giving him +7 Damage Up and +30 Range Up for the rest of the current room
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Coper140
Unlock this item by getting 5 items or consumables that increase your size, e.g. 'One Makes you Larger' pills, Magic Mushroom etc
Ancient Recall
CardID: 53
"Draw 3 cards"
Spawns 3 random cards on the floor when used
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Coper140
Era Walk
CardID: 54
"Savor the moment"
When used, this card will slow down enemies, Isaac's tears by -1 Shot Speed, but speed up Isaac's movement speed by +0.50 for the rest of the current room
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Coper140
Unlock this item by getting both the Broken Watch and the Stop Watch in your collection
Credit Card
CardID: 43
"Charge it!"
When used, removes the price tag from all items in the current shop or devil deal, making everything free
The effect of the Credit Card only lasts for the current room
Unlock this card by beating Challenge #10 (Cursed!)
Rules Card
CardID: 44
"???"
Displays a random cryptic message on the screen similar to the fortune machine ones. One of the following messages may show:
'Rooms may yield more than you expect'
'Some doors require a blessing. Carry them with you'
'The walls will harden over time. Time is the essence'
'Sleeping gatekeepers will need to be awoken with a loud sound'
'A piece of paper is your guide'
'Deny his gifts to attain your reward'
'A dark market lies under your feet
'Chub dislikes smoke!'
Unlock this card by beating Challenge #11 (Glass Cannon)
Card Against Humanity
CardID: 45
"Something stinks..."
When used, fills the entire room with poop!
Unlock this card by beating Challenge #12 (When Life Gives You Lemons)
Get Out Of Jail Free Card
CardID: 47
"Open sesame"
When used, will open all doors in the current room, similar to a one-time use of Dad's Key
Unlock this card by beating Challenge #22 (Speed)
? Card
CardID: 48
"Double active"
When used this card will activate a use of your spacebar item for free
Rune of Hagalaz
CardID: 32
"Destruction"
When used, this rune will destroy all breakable objects in the current room, such as poop, rocks, secret room entrances
This includes Key Blocks
Unlock this card by beating Challenge #1 (Pitch Black)
Rune of Jera
CardID: 33
"Abundance"
When used this rune will double all pickups on the floor in the room
Creates copies of pickups in the Shop which can be taken for free, even if you haven't purchased them yet
Can be used to double the number of item chests in the first room of the final Chest / Dark Room floors
Cloned chests have the same types of items as the first one
Cannot be used to clone trinkets or other Jera runes
Unlock this card by beating Challenge #2 (High Brow)
Rune of Ehwaz
CardID: 34
"Passage"
Creates a trapdoor on the floor
Digging in certain spots with objects or markings on the floor will guarantee a crawlspace once per floor
Unlock this card by beating Challenge #3 (Head Trauma)
Rune of Dagaz
CardID: 35
"Purity"
Removes the curse which is in effect on the current floor (except Curse of the Labyrinth)
Can also cure the effect of the Amnesia pill
+1 Soul Heart
Unlock this card by beating Challenge #4 (Darkness Falls)
Rune of Ansuz
CardID: 36
"Vision"
When used, reveals the entire map including all the secret room locations and other icon rooms
Unlock this card by beating Challenge #5 (The Tank)
Rune of Perthro
CardID: 37
"Change"
Rerolls all pedestal items in the current room (One time use of the D6)
Unlock this card by beating Challenge #6 (Solar System)
Rune of Berkano
CardID: 38
"Companionship"
Summons 3 blue friendly spiders and 3 blue flies
Unlock this card by beating Challenge #20 (Purist)
Rune of Algiz
CardID: 39
"Resistance"
When used, gives you an invincibility effect which lasts for 20 seconds
Unlock this card by beating Challenge #8 (Cat Got Your Tongue)
Blank Rune
CardID: 40
"???"
When used, gives a random Mystic rune effect
Possible effects include: Algiz, Ansuz, Berkano, Dagaz, Ehwaz, Hagalaz, Jera, Perthro
Also has a 25% chance to spawn another Blank Rune upon use
Unlock this card by beating Challenge #30 (Guardian)
Black Rune
CardID: 41
"Void"
When used, this rune deals 40 damage to all enemies in the room and consumes all pedestal items in the room, giving you a random stat increase for each item consumed
Also consumes all pickups in the room and turns them into blue flies and spiders
Unlock this item by beating Greedier mode as Apollyon
Rune Shard
CardID: 55
"It still glows faintly"
Activates a random rune effect. The effect is weaker than normal runes.
These only appear if not all runes have been unlocked yet.
Dice Shard
CardID: 49
Gives a one-time use of the D6 and D20 effects at the same time
Emergency Contact
CardID: 50
"Help from above"
When used will cause two of Mom's Hand to come down and grab a random enemy
Holy Card
CardID: 51
"You feel protected"
Grants the Holy Mantle effect for, which will negate your next hit of damage
The effect persist between rooms/floors
Tainted Lost starts with this card, and while playing as this character all cards and runes have a 10% chance to turn into a Holy Card
Unlock this item by defeating Delirium in The Void floor with The Lost
Cracked Key
CardID: 78
"???"
This is a one-time use of the Red Key item.
The main purpose of the Cracked Key is to unlock Tainted character in the Home floor without needing to find the Red Key. You can force spawn a cracked key by droping any trinket in a Boss Room or Item room, on any floor on your way down to Depths II. When you take the reverse path back up to Home, the trinket will turn into Cracked Key in the same floor/room you dropped it before.
Unlock this card by opening Mom's Box on the Home floor.
O - The Fool?
CardID: 56
"Let go and move on"
When used, this card drops all of your hearts (including non-red hearts), coins, keys and bombs on the floor
This effect is done in the most efficient way possible - e.g. if you have 99 coins it will create 3 x Quarters, 2 Dimes and 4 Pennies. If you have 40 bombs it will spawn 4 x Boom! pedestal items
Picking up all dropped items leaves you with the same health and consumables you had before
This allows you to manipulate your consumables in lots of different ways, for example by rerolling them with the D6/D20, re-arrange your Bone heart containers and more
If you have the Tarot Cloth item, this card will also drop all your passive items on the floor as pedestals
Unlock this card by defeating Ultra Greedier mode as Tainted Lost
I - The Magician?
CardID: 57
"May no harm come to you"
Gives you a blue aura that repels enemy projectiles, causing them to slowly curve away from Isaac and avoid hitting him
Lasts for 60 seconds
Unlock this card by defeating Ultra Greedier mode as Tainted Judas
II - The High Priestess?
CardID: 58
"Run"
Causes Mom's Foot to keep stomping down randomly for 60 seconds where Isaac is standing
Unlock this card by defeating Ultra Greedier mode as Tainted Lilith
III - The Empress?
CardID: 59
"May your love bring protection"
Gives 2 HP Up and +1.5 Tears Up for 60 seconds
Unlock this card by defeating Ultra Greedier mode as Tainted Eve
IV - The Emperor?
CardID: 60
"May you find a worthy opponent"
Teleports you to an extra boss room, that drops a Boss room item as normal. This room isn't part of the actual floor, and leaving it returns you to where you teleported from
The boss isn't necessarily from the current floor - e.g. you could find a caves boss in the basement
Unlock this card by defeating Ultra Greedier mode as Tainted ???
V - The Hierophant?
CardID: 61
"Two prayers for the forgotten"
Spawns 2 Bone hearts on the floor
Unlock this card by defeating Ultra Greedier mode as Tainted Bethany
VI - The Lovers?
CardID: 62
"May your heart shatter to pieces"
Spawns a random pedestal item from the current room's item pool
In exchange, turns one heart container or 2 soul hearts into a broken heart. Broken hearts permanently subtract from your total possible health containers
Unlock this card by defeating Ultra Greedier mode as Tainted Magdalene
VII - The Chariot?
CardID: 63
"May nothing walk past you"
Isaac turns to stone and can't move for 10 seconds, but your tear rate goes up significantly for the duration
Unlock this card by defeating challenge #42 (Hot Potato)
VIII - Justice?
CardID: 64
"May your sins come back to torment you"
Spawns 2-4 locked gold chests
Unlock this card by defeating challenge #43 (Cantripped)
IX - The Hermit?
CardID: 65
"May you see the value of all things in life"
When used, all items and pickups in the current room are turned into money. Everything is sold for its shop price, e.g. Items for 15c, hearts for 3c, sacks for 7c
Unlock this card by defeating challenge #44 (Red Redemption)
X - Wheel of Fortune?
CardID: 66
"Throw the dice of fate"
Activates a random effect from a Dice room
See the dice icon above for each possible effect
Unlock this card by defeating Ultra Greedier mode as Tainted Cain
XI - Strength?
CardID: 67
"May you break their resolve"
All enemies in the current room are slowed and take double damage
Unlock this card by defeating Ultra Greedier mode as Tainted Samson
XII - The Hanged Man?
CardID: 68
"May your greed know no bounds"
You turn into the Keeper, gaining triple shot, -0.1 Speed Down for 30 seconds
Enemies drop random coins while this effect is active
Unlock this card by defeating Ultra Greedier mode as Tainted Keeper
XIII - Death?
CardID: 69
"May life spring forth from the fallen"
Activates the Book of the Dead effect, spawning a bone orbital or charmed Bony for each enemy killed in the current room
Unlock this card by defeating Ultra Greedier mode as Tainted Forgotten
XIV - Temperance?
CardID: 70
"May your hunger be satiated"
When used, this card activates 5 random pill effects one after the other
Unlock this card by defeating challenge #45 (DELETE THIS)
XV - The Devil?
CardID: 71
"Bask in the light of your mercy"
Activates The Bible effect (granting flight) and gives a Seraphim familiar for 30 seconds
Unlock this card by defeating Ultra Greedier mode as Tainted Azazel
XVI - The Tower?
CardID: 72
"Creation brings destruction"
Spawns 6 clusters of rocks and objects that normally appear on this floor
It won't block any doors that exist
Rocks have a pretty good chance to become tinted rocks
Unlock this card by defeating Ultra Greedier mode as Tainted Apollyon
XVII - The Stars?
CardID: 73
"May your loss bring fortune"
Removes your oldest item and spawns 2 pedestal items from the current room's pool
Can remove either passive or active items
Doesn't remove your character's starting items
Unlock this card by defeating Ultra Greedier mode as Tainted Isaac
XVIII - The Moon?
CardID: 74
"May you remember lost memories"
Teleports you to the ultra secret room on the floor
The ultra secret room is a red room containing an item from the angel room item pool. Can only be accessed via the Red Key, Crystal Key or Cracked Key. Using this card will also open a pathway of red rooms back to the regular floor
Unlock this card by defeating Ultra Greedier mode as Tainted Jacob
XIX - The Sun?
CardID: 75
"May the darkness swallow all around you"
When used, grants +1.5 Damage Up, turns your hearts to Bone hearts and the Spirit of the Night effect (Spectral tears and the ability to fly) for the current floor
Also gives the Curse of Darkness effect that can't be removed for the current floor
Unlock this card by defeating Ultra Greedier mode as Tainted Jacob
XX - Judgement?
CardID: 76
"May you redeem those found wanting"
Spawns a Restock machine
Unlock this card by defeating Ultra Greedier mode as Tainted Lazarus
XXI - The World?
CardID: 77
"Step into the abyss"
Creates a trapdoor to a guaranteed crawl space
Unlock this card by defeating Ultra Greedier mode as Tainted Eden
Wild Card
CardID: 80
"Again"
When used, this copies the effect of the card, pill, rune, soul stone or active item you used most recently
Unlock this card by defeating Mega Satan as Tainted Eden
Soul of Isaac
CardID: 81
"Reroll... or not"
Turns all pedestal items in the current room into rotating items, which cycle between the old item and a random new item every second
This allows you to effectively reroll items like with The D6, but choose the old item as well if you want
Tainted Isaac has this effect passively for all items
If you use more than one in the same room, each pedestal item will cycle through +1 random item
Items are chosen from the item pool related to the current item
Unlock this item by defeating Hush and Boss Rush as Tainted Isaac
Soul of Magdalene
CardID: 82
"Give me your love!"
When used, all enemies in the current room drop half a red heart that will disappear after 2 seconds if not picked up
Unlock this item by defeating Hush and Boss Rush as Tainted Magdalene
Soul of Cain
CardID: 83
"Opens the unopenable"
When used, this Soul Stone creates Red rooms for every possible exit in the current room
Red outlines of doors appear where this Soul Stone will create exits for
See the Red Key item description for more information about these Red rooms behave
Unlock this item by defeating Hush and Boss Rush as Tainted Cain
Soul of Judas
CardID: 84
"Right behind you"
Activates the Dark Arts item effect, which turns Isaac into a ghost for a few seconds. While in this form you can walk over enemies to mark them for death. After a few seconds, he will quickly attack each target, chaining higher damage for each enemy it hits
Unlock this item by defeating Hush and Boss Rush as Tainted Judas
Soul of ???
CardID: 85
"Chemical warfare"
When used this will cause 8 poison farts that leave a brown creep behind, and then drop 7 Butt Bombs very quickly
Standing in the creep gives you +1 Damage Up and +1.35 Tears Up
Unlock this item by defeating Hush and Boss Rush as Tainted Blue Baby
Soul of Eve
CardID: 86
"Your very own murder"
For the current room, 14 Dead Birds fly in from off the screen and attack all enemies, dealing low but frequent damage
Unlock this item by defeating Hush and Boss Rush as Tainted Eve
Soul of Samson
CardID: 87
"Slay a thousand"
Isaac gains the Berserk! effect for 10 seconds. This gives Isaac a bone sword and he goes on a killing rampage, gaining +0.4 Speed, +3 Flat Damage Up
Unlock this item by defeating Hush and Boss Rush as Tainted Samson
Soul of Azazel
CardID: 88
"Demon rage!"
Activates the Mega Blast item effect, which gives you a giant laser that deals x5 your tear damage per tick to anything in its path and pushing Isaac back by the force
The effect lasts for 8 seconds but does persist between rooms
Unlock this item by defeating Hush and Boss Rush as Tainted Azazel
Soul of Lazarus
CardID: 89
"Life after death"
When used this kills Isaac and revives him with 1/2 a red heart. You get a couple of seconds of invincibility to move away after
The main benefit of this Soul Stone is that it automatically activates if you die, meaning it is effectively an extra passive life while held
Unlock this item by defeating Hush and Boss Rush as Tainted Lazarus
Soul of Eden
CardID: 90
"Embrace chaos"
Activates the D6 and D20 effects, rerolling all items and pickups in the room. Unlike the regular D6, rerolled items can pick from any item pool
Unlock this item by defeating Hush and Boss Rush as Tainted Eden
Soul of the Lost
CardID: 91
"Leave your body behind"
When used, Isaac dies and becomes The Lost for the current room. This gives you his ability to fly, and the Holy Mantle effect. However if you take damage a second time you die like the Lost does
Same effect as touching a white fire, but only lasts one room
Unlock this item by defeating Hush and Boss Rush as Tainted Lost
Soul of Lilith
CardID: 92
"Motherhood"
Gives you 1 random permanent familiar
Unlock this item by defeating Hush and Boss Rush as Tainted Lilith
Soul of the Keeper
CardID: 93
"$$$"
Spawns up to 25 random coins on the floor
Unlock this item by defeating Hush and Boss Rush as Tainted Keeper
Soul of Apollyon
CardID: 94
"Bringer of calamity"
Creates 15 random Locusts
Locusts are variants of blue flies, except they have special effects based on the color
War (Red) - Explodes when touching the enemy. The actual explosion deals flat 60 damage
Pestilence (Green) - Poisons the enemy it attacks
Famine (Brown) - Applies a slowing effect
Death (Black) - Deals x4 damage instead of x2
Conquest (White) - Spawns 2-5 at once
Unlock this item by defeating Hush and Boss Rush as Tainted Apollyon
Soul of the Forgotten
CardID: 95
"Skeletal protector"
Gives you The Forgotten as a temporary familiar, with 2 Bone hearts and his bone weapon. He behaves the same as how Esau works with Jacob, following your exact movements
Disappears after the current room or if he takes enough damage and dies
Unlock this item by defeating Hush and Boss Rush as Tainted Forgotten
Soul of Bethany
CardID: 96
"Friends from beyond"
Creates 6 wisps, similar to the Book of Virtues effect
Mosts wisps will be the standard blue ones, but have a chance to have random special properties
Unlock this item by defeating Hush and Boss Rush as Tainted Bethany
Soul of Jacob and Esau
CardID: 97
"Bound by blood"
Spawns Esau as a temporary familiar, who copies your exact movements the same as how the Jacob & Esau character works
Disappears after the current room or if he takes enough damage and dies
Unlock this item by defeating Hush and Boss Rush as Tainted Jacob
Gold Key
Once picked up, you gain unlimited key use for the rest of the floor
Using a 'Bombs are Key' pill with this effect will swap your Gold Key for a Gold Bomb
Gold Bomb
Once picked up, you gain unlimited bomb use for the rest of the floor
Using a 'Bombs are Key' pill with this effect will swap your Gold Bomb for a Gold Key
Unlock this item by beating challenge #23 (Blue Bomber)
Golden Battery
Fully charges your active item when picked up
Also, you take a full heart of damage when picked up. Doing this will cause this Golden Battery to reappear somewhere else on the floor
Unlock this by defeating Mega Satan as Tainted Forgotten
Golden Troll Bomb
Spawns similar to regular troll bombs and cannot be picked up
However, they will explode forever instead of disappearing
The Safety Scissors trinket will turn this into a gold bomb
Golden Penny
When picked up, will respawn again at a random location in the room
Every time you pick up a golden penny it has a 5% chance to disappear completely
Unlock this by defeating Mega Satan as Tainted Keeper
Gold Heart
Once picked up, the gold heart will drop money on the floor the next time Isaac loses a heart
Unlock this item by beating challenge #21 (XXXXXXXXL)
Bone Heart
Takes three hits to deplete and can be refilled with red hearts, but disappears forever when depleted
Unlock this item by unlocking the Forgotten character. See the Broken Shovel / Mom's Shovel items for more information on how to unlock
Rotten Heart
Rotten Hearts fill up a whole container the same as normal red hearts, or the rightmost heart if you're at full health
Every time you clear a room, you'll spawn 2 Blue Flies for each Rotten Heart you currently have
Unlock this by entering the Corpse floor for the first time
Black Sack
Spawns 2-3 pills, black/bone hearts and/or bombs when picked up
Can spawn in place of a regular sack, including in Shops for 7c
Only one heart can spawn per sack as a maximum
Unlock this by defeating Mega Satan as Tainted Judas
Rebirth Pills A - L
48 Hour Energy - Fully recharges your active item and drops 1-2 battery pickups. Can be used with Placebo to generate infinite batteries
Amnesia - Hides the floor map for the rest of the current floor (same as curse of the lost). Can be negated with Black Candle
Bad Gas - Isaac farts, poisoning enemies around him
Bad Trip - Deals damage to yourself
Balls of Steel - +2 Soul Hearts
Bombs are key - Switches number of bombs and keys
Explosive Diarrhea - Spawns five live troll bombs behind Isaac, one per second
Full Health - Restores all your empty red heart containers
Health Down - -1 HP. If you have 1 or less heart containers, this pill becomes Health Up
Health Up - +1 HP
Hematemesis - Empties all but one red heart container and spawns 1-4 red hearts on the floor. Spawns coins as The Keeper
I can see forever - Opens secret room and super secret room entrances on the current floor
I found pills - Changes the appearance of Isaac's face for the current room (Cosmetic change only)
Lemon Party - Spawns a large yellow pool on the floor around you, damaging enemies which walk in it
Luck Down - Reduces your luck stat by -1
Luck Up - Increases your luck stat by +1
Rebirth Pills P - Z
Paralysis - Prevents you from moving for a short while
Pheromones - Applies the charm effect to all enemies in the room for a short while
Puberty - Causes Isaac to grow hair for the rest of the run. Cosmetic change only. In Afterbirth+, taking 3 of this pill gives the Adult transformation
Pretty Fly - Gives Isaac +1 fly orbital, which blocks enemy projectiles and damages fly-type enemies on touch
Range Down - Reduces your range stat by -2
Range Up - Increases your range stat by +2.5
R U a wizard? - Tears will shoot diagonally for about 60 seconds. Effect persists between rooms while the time period is active
Speed Down - Reduces your speed stat by -0.12
Speed Up - Increases your speed stat by +0.15
Tears Down - Reduces your tears stat by -0.28
Tears Up - Increases your tears stat by 0.35
Telepills - Teleports you to a random room when used. Has a small chance to take you to the I AM ERROR room, and a smaller chance to teleport to a Black Market
Afterbirth Pills
Addicted - Causes you to take a full heart of damage for all sources for the current room. Unlocked from Challenge #24 - PAY TO PLAY
Friends till the end - Spawns three friendly blue attack flies
Infested! - Destroys all poops in the room and spawns a blue attack spider on every destroyed poop
Infested? - Spawns one blue attack spider for every enemy in the room. If there are no enemies this pill spawns 1-3 blue spiders instead
One makes you smaller - Reduces Isaac's size and hitbox size
One makes you larger - Increases Isaac's size, but does not affect the size of his hitbox
Percs - Causes Isaac to only take half a heart of damage from all sources for the current room (The Wafer effect). Unlocked from Challenge #24 - PAY TO PLAY
Power Pill - Gives you invulnerability and the ability to damage enemies for a short while (similar to The Gamekid effect)
Re-Lax - Causes Isaac to spawn poops behind him while he walks for a few seconds. Similar to Explosive Diarrhea but with poop
Retro Vision - Pixelates the screen for a few seconds, obscuring your vision. Happens a total of 3 times over 30 seconds
??? - Gives the curse of the maze effect for the current floor. Unlocked from Challenge #25 - Have a Heart
Afterbirth+ Pills
Feels like I'm walking on sunshine! - Turns Isaac invincible for a few seconds (similar to Unicorn Stump). Unlocked from the 'Sin Collector' achievement (collect every Bestiary entry)
Gulp! - When used will consume your current trinket, destroying it and giving you its effect permanently. Unlocked from the 'Once more with the feeling!' achievement (complete a victory lap, defeating the lamb boss)
Horf! - When used, shoots an Ipecac explosive shot. Unlocked from the 'Dedication' achievement (participate in 31 dailies in a row)
I'm Drowsy... - Slows all enemies for the rest of the current room
I'm excited!!! - Speeds up all enemies for the rest of the room. The effect triggers again 30 seconds after use and again 60 seconds after use
Something's wrong... - Spawns a pool of black creep beneath Isaac
Vurp! - Spawns the last pill you used. Spawns another Vurp! pill if no other pills were used yet. Unlocked from the 'U broke it!' achievement (collect 50 items in a single run)
X-Lax - Spawns a pool of slippery brown creep beneath Isaac
Repentance Pills
Shot Speed Down - -0.15 shot speed
Shot Speed Up - +0.15 shot speed
Experimental Pill - Increases one random stat and decreases another random stat. Amount changed equals the equivalent stat up/down pill. If you have PhD it will only increase one stat
Gold Pill
When used gives a random pill effect
Can be used multiple times, but every time you use it, it has a chance to disappear
The Gold Pill can spawn as a Horse Pill, which then causes it to give random Horse pill effects
Unlock this by defeating Mega Satan as Tainted Cain
Horse Pills
Horse Pills rarely spawn as larger versions of normal pills with more powerful effects
Items that synergize with pills also have the same effect with Horse pills
In general, the effect of a Horse Pill is double the effect of a normal pill i.e. Speed Up will be +0.3 instead of +0.15. Pills with effects that can't necessarily 'double' are stronger, i.e. Pretty Fly gives a Big Fan item rather than a fly orbital
Unlock this by defeating Mega Satan as Tainted Eve
Dice Rooms
1 Dot - Rerolls all of your items. (Does not change your trinkets, pills or cards)
2 Dot - Rerolls all pickups in the room. (D20 effect)
3 Dot - Rerolls all pickups on the entire floor
4 Dot - Rerolls all pedestal items on the floor. (Does not roll your devil deal items)
5 Dot - Reroll and restart the current floor (Forget Me Now effect)
6 Dot - Reroll all of your items and all the pickups on the entire floor (Combined 1 + 3 + 4 rooms)