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Isaac Cheat Sheet (Afterbirth+)

Rebirth Items (341)

  • The Sad Onion

    ItemID: 1

    "Tears up"

    +0.7 Tears Up

      Type: Passive

      Item Pool: Item Room

    * item room, treasure room, item room pool, green, cry, plant

  • The Inner Eye

    ItemID: 2

    "Triple shot"

    Tears now shoot three at a time (Triple Shot)

    Tears Down significantly (tears = tears * 2.1 + 3).

      Type: Passive, Tear Modifier

      Item Pool: Item Room

    * item room, treasure room, item room pool, round, circle, white

  • Spoon Bender

    ItemID: 3

    "Homing shots"

    Gives Isaac's tears a homing effect.

      Type: Passive

      Item Pool: Item Room

    * item room, treasure room, item room pool, grey, gray, bent

  • Cricket's Head

    ItemID: 4

    "DMG up"

    +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, Gold Chest

    * item room, treasure room, item room pool, golden chest pool, gold chest pool, cat, dead, brown, pink

  • My Reflection

    ItemID: 5

    "Boomerang tears"

    Gives tears a boomerang effect.

    +1.5 Range Up.

    +0.6 Shot Speed Up.

    +1 Tear Height.

      Type: Passive, Tear Modifier

      Item Pool: Item Room

    * item room, treasure room, item room pool, broken, mirror, cracked, grey, gray, silver

  • Number One

    ItemID: 6

    "Tears up"

    Gives you a very high tear rate in exchange for a big range down.

    +1.5 Tears Up.

    -17.62 Range Down.

    +0.76 Tear Height.

      Type: Passive

      Item Pool: Item Room

    * item room, treasure room, item room pool, mm sweet lemonade, urine, yellow, tear, drop

  • Blood of the Martyr

    ItemID: 7

    "DMG up"

    +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

    * item room, treasure room, item room pool, crown, thorns, brown, hat

  • Brother Bobby

    ItemID: 8

    "Friends 'till the end"

    A familiar which follows Isaac and shoots normal tears which do 3.5 damage.

    Brother Bobby 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

    * item room, treasure room, item room pool, devil pool, devil room pool, devil deal, purple, blue, dead, baby

  • Skatole

    ItemID: 9

    "Fly love"

    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.

      Type: Passive

      Item Pool: None (Arcade shell game only)

    * arcade, skull game, black, heart, pink, love

  • Halo of Flies

    ItemID: 10

    "Projectile protection"

    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

    * item room, treasure room, item room pool, key master pool, key beggar pool, key judgement pool, two, flies, black

  • 1UP

    ItemID: 11

    "Extra life"

    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

    * secret room pool, mario, green mushroom, extra life, spots, spotted

  • Magic Mushroom

    ItemID: 12

    "All stats up!"

    +1 Health 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).

    +5.25 Range Up.

    +0.3 Speed Up.

    +0.5 Tear Height.

    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, Boss Room, Mushrooms

    * boss room pool, boss room item, item room, treasure room, item room pool, red, spots, spotted, amanita muscaria

  • The Virus

    ItemID: 13

    "Poison touch"

    Deals poison damage on contact with enemies (Damage over time 4 or 6 per tick).

    -0.1 Speed Down

    Has a chance to drop from the Lust miniboss fight.

    Counts as 1 of 3 syringe items needed towards the Spun transformation.

    In Afterbirth this item has a 20% chance to cause enemies to drop black hearts if it was poisoned.

      Type: Passive

      Item Pool: Item Room, Demon Beggar, Lust Miniboss

    * demon beggar pool, demon judgement pool, devil beggar pool, item room, treasure room, item room pool, syringe, needle, injection, the lost item pool, red

  • Roid Rage

    ItemID: 14

    "Speed and range up"

    +0.6 Speed Up.

    +5.25 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

    * demon beggar pool, demon judgement pool, devil beggar pool, boss room pool, boss room item, item room, treasure room, item room pool, syringe, needle, injection, green

  • <3

    ItemID: 15

    "HP up"

    +1 Health Up

    Fully restores all red heart containers

    Has a chance to drop from the Gluttony miniboss fight.

      Type: Passive

      Item Pool: Item Room, Boss Room, Gluttony Miniboss

    * boss room pool, boss room item, item room, treasure room, item room pool, red heart, ballchinnian, ball sack, full heal, gluttony, the lost item pool

  • Raw Liver

    ItemID: 16

    "HP up"

    +2 Health Up.

    Full red heart heal.

      Type: Passive

      Item Pool: Secret Room

    * secret room pool, the lost item pool, brown, poop, turd

  • Skeleton Key

    ItemID: 17

    "99 keys"

    Gives Isaac 99 Keys

      Type: Passive

      Item Pool: Secret Room

    * secret room pool, silver, grey, gray, skull

  • A Dollar

    ItemID: 18

    "$$$"

    Gives Isaac 99 coins.

    Can drop from an exploding slot machine while playing it.

      Type: Passive

      Item Pool: None (Arcade machine only)

    * slot machine, arcade machine, money, bill, cash, green

  • Boom!

    ItemID: 19

    "10 bombs"

    +10 Bombs

      Type: Passive

      Item Pool: Item Room, Bomb Beggar

    * boss rush pool, boss rush room, item room, treasure room, item room pool, grey, gray, x10

  • Transcendence

    ItemID: 20

    "We all float down here..."

    Gives Isaac the ability to fly.

    UNLOCK: Unlock this item by beating Mom's Heart 3 times.

      Type: Passive

      Item Pool: Secret Room

    * secret room pool, the lost item pool, brown, noose, hang

  • The Compass

    ItemID: 21

    "The end is near"

    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

    * normal beggar pool, normal judgement pool, coin beggar pool, coin judgement pool, shop room pool, shop item pool, pink, red

  • Lunch

    ItemID: 22

    "HP up"

    +1 Health Up.

      Type: Passive

      Item Pool: Boss Room, Challenge Room, Beggar

    * dungeon room, blood challenge room, arena pool, normal beggar pool, normal judgement pool, coin beggar pool, coin judgement pool, boss room pool, boss room item, the lost item pool, brown, bowl, grey, gray, poop, fly

  • Dinner

    ItemID: 23

    "HP up"

    +1 Health Up.

      Type: Passive

      Item Pool: Boss Room, Beggar, Challenge Room

    * dungeon room, blood challenge room, arena pool, normal beggar pool, normal judgement pool, coin beggar pool, coin judgement pool, boss room pool, boss room item, the lost item pool, dog, can, tin, brown

  • Dessert

    ItemID: 24

    "HP up"

    +1 Health Up.

      Type: Passive

      Item Pool: Boss Room, Beggar, Challenge Room

    * dungeon room, blood challenge room, arena pool, normal beggar pool, normal judgement pool, coin beggar pool, coin judgement pool, boss room pool, boss room item, the lost item pool, dog, brown, sack, bag, fly

  • Breakfast

    ItemID: 25

    "HP up"

    +1 Health Up.

      Type: Passive

      Item Pool: Boss Room, Challenge Room, Beggar

    * dungeon room, blood challenge room, arena pool, normal beggar pool, normal judgement pool, coin beggar pool, coin judgement pool, boss room pool, boss room item, the lost item pool, carton, fly, flies, milk

  • Rotten Meat

    ItemID: 26

    "HP up"

    +1 Health Up

      Type: Passive

      Item Pool: Boss Room, Beggar, Challenge Room

    * dungeon room, blood challenge room, arena pool, normal beggar pool, normal judgement pool, coin beggar pool, coin judgement pool, boss room pool, boss room item, the lost item pool, green, bone, lump, yellow

  • Wooden Spoon

    ItemID: 27

    "Speed up"

    +0.3 Speed Up.

      Type: Passive

      Item Pool: Boss Room

    * boss room pool, boss room item, brown

  • The Belt

    ItemID: 28

    "Speed up"

    +0.3 Speed Up.

      Type: Passive

      Item Pool: Boss Room

    * boss room pool, boss room item, brown, leather, bag, sack

  • Mom's Underwear

    ItemID: 29

    "Range Up"

    +5.25 Range Up

    +0.5 Tear Height.

    Counts as 1 of 3 mom items needed towards the Mom transformation.

      Type: Passive

      Item Pool: Boss Room, Challenge Room

    * dungeon room, blood challenge room, arena pool, boss room pool, boss room item, panties, pants, under wear, pink, knickers

  • Mom's Heels

    ItemID: 30

    "Range up"

    +5.25 Range Up

    +0.5 Tear Height.

    Counts as 1 of 3 mom items needed towards the Mom transformation.

      Type: Passive

      Item Pool: Boss Room, Challenge Room

    * dungeon room, blood challenge room, arena pool, boss room pool, boss room item, red, high, shoe

  • Mom's Lipstick

    ItemID: 31

    "Range up"

    +5.25 Range Up

    +0.5 Tear Height.

    Counts as 1 of 3 mom items needed towards the Mom transformation.

      Type: Passive

      Item Pool: Boss Room, Challenge Room

    * dungeon room, blood challenge room, arena pool, boss room pool, boss room item, red, grey, gray

  • Wire Coat Hanger

    ItemID: 32

    "Tears up"

    +0.7 Tears Up.

    UNLOCK: Unlock this item by beating Mom's Heart 4 times.

      Type: Passive

      Item Pool: Boss Room

    * boss room pool, boss room item, black

  • The Bible

    ItemID: 33

    "Temporary flight"

    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: 6 rooms.

      Item Pool: Shop, Library, Angel Room

    * library pool, library room, book room pool, angel room pool, god room pool, angel room item, shop room pool, shop item pool, cross, brown

  • The Book of Belial

    ItemID: 34

    "Temporary DMG up"

    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% (Before Afterbirth DLC this was a guaranteed 100%)

    Judas starts with this item.

    The effect stacks if used multiple times.

    Counts as 1 of 3 book items needed towards the Bookworm transformation.

      Type: Active

      Recharge Time: 3 rooms

      Item Pool: Library, Devil Room

    * library pool, library room, book room pool, devil pool, devil room pool, devil deal, starting grey, gray, pentagram

  • The Necronomicon

    ItemID: 35

    "Mass room damage"

    Deals 40 damage to everything in the room when used.

    Counts as 1 of 3 book items needed towards the Bookworm transformation.

    UNLOCK: Unlock this item by using 4 XIII - Death cards.

      Type: Active

      Recharge Time: 6 rooms

      Item Pool: Library, Secret Room, Devil Room

    * library pool, library room, book room pool, secret room pool, devil pool, devil room pool, devil deal, pink, brown, face, spots

  • The Poop

    ItemID: 36

    "Plop!"

    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

    * item room, treasure room, item room pool, starting, turd, brown

  • Mr. Boom

    ItemID: 37

    "Reusable bomb buddy"

    Drops a large bomb below the player which does 110 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

    * boss rush pool, boss rush room, item room, treasure room, item room pool, bomb beggar, face, smile, grey, gray

  • Tammy's Head

    ItemID: 38

    "Reusable tear burst"

    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.

    Synergizes extremely well with Brimstone due to how the damage from both items is calculated when combined.

      Type: Active

      Recharge Time: 1 room

      Item Pool: Gold Chest

    * golden chest pool, gold chest pool, dead, cat, white, yellow

  • Mom's Bra

    ItemID: 39

    "Mass fear"

    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

    * dungeon room, blood challenge room, arena pool, item room, treasure room, item room pool, white, brown, underwear

  • Kamikaze

    ItemID: 40

    "Become the bomb!"

    Causes an explosion near Isaac which takes away half a heart and does 40 damage all enemies in close proximity.

      Type: Active

      Recharge Time: Instant

      Item Pool: Item Room

    * item room, treasure room, item room pool, the lost item pool, bomb, tnt, clock, red

  • Mom's Pad

    ItemID: 41

    "Gross..."

    When used, causes all enemies in the current room to run away from Isaac in fear for 5 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

    * item room, treasure room, item room pool, dungeon room, blood challenge room, arena pool, white, grey, gray

  • Bob's Rotten Head

    ItemID: 42

    "Reusable ranged bomb"

    A poison bomb which can be thrown and leaves a poison effect on any enemies within the blast radius.

    The bomb deals 50 damage on hit and leaves a damage over time poison effect that does 3 times your tear damage per tick. Before Afterbirth this was 6 or 8 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: 3 rooms

      Item Pool: Item Room, Gold Chest, Sloth Miniboss

    * golden chest pool, gold chest pool, item room, treasure room, item room pool, bob sloth, grey, gray, green, mouth

  • Teleport

    ItemID: 44

    "Teleport!"

    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

    * item room, treasure room, item room pool, blue remote, robot

  • Yum Heart

    ItemID: 45

    "Reusable regeneration"

    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

    * item room, treasure room, item room pool, the lost item pool, maggy, starting, red, pink, broken

  • Lucky Foot

    ItemID: 46

    "Luck up"

    +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.

      Type: Passive

      Item Pool: Item Room, Beggar

    * normal beggar pool, normal judgement pool, coin beggar pool, coin judgement pool, item room, treasure room, item room pool, starting, pink, white, yellow

  • Doctor's Remote

    ItemID: 47

    "Reusable air strike"

    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

    * item room, treasure room, item room pool, grey, gray, robot

  • Cupid's Arrow

    ItemID: 48

    "Piercing shots"

    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

    * item room, treasure room, item room pool, arrow, penetrative, penetrating shots, grey, gray, red, bolt

  • Shoop Da Whoop!

    ItemID: 49

    "BLLLARRRRGGG!"

    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

    * item room, treasure room, item room pool, red, lips, white, eyes

  • Steven

    ItemID: 50

    "DMG up"

    +1 Damage Up.

    Can be found in gold chests, or dropped by the Steven boss. Before afterbirth this wasn't in the gold chest item pool

    UNLOCK: Unlock this item by beating the Basement 40 times and defeating the Steven boss.

      Type: Passive

      Item Pool: Gold Chest, Steven Boss

    *, black, white, face, eyes, mouth, golden chest pool

  • Pentagram

    ItemID: 51

    "DMG up"

    +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

    * curse room pool, devil pool, devil room pool, devil deal, boss room pool, boss room item, satanic, star, red, black

  • Dr. Fetus

    Special item

    ItemID: 52

    "???"

    Instead of tears, Isaac now shoots bombs from his eyes, which explode dealing damage to anything nearby.

    Bomb damage = damage * 5 + 30 (Pre-afterbirth this was damage * 3).

    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.

    UNLOCK: Unlock this item by beating Mom's Heart 9 times.

      Type: Passive, Tear Modifier

      Item Pool: Item Room

    * item room, treasure room, item room pool, baby, fetus, foetus, jar, white, pink, bug, dr fetus

  • Magneto

    ItemID: 53

    "Item snatcher"

    Causes pickups on the floor move towards the player.

    Works across pits, but not through Key blocks.

      Type: Passive

      Item Pool: Item Room

    * item room, treasure room, item room pool, red, horse shoe

  • Treasure Map

    ItemID: 54

    "Full visible map"

    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

    * normal beggar pool, normal judgement pool, coin beggar pool, coin judgement pool, shop room pool, shop item pool, brown, x, cross, paper

  • Mom's Eye

    ItemID: 55

    "Eye in the back of your head"

    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 +2 Luck.

    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

    * dungeon room, blood challenge room, arena pool, item room, treasure room, item room pool, white, red

  • Lemon Mishap

    ItemID: 56

    "Oops..."

    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

    * item room, treasure room, item room pool, yellow

  • Distant Admiration

    ItemID: 57

    "Attack fly"

    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

    * key master pool, key beggar pool, key judgement pool, item room, treasure room, item room pool, grey, gray

  • Book of Shadows

    ItemID: 58

    "Temporary invincibility"

    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

    * library pool, library room, book room pool, item room, treasure room, item room pool, white, pink

  • The Ladder

    ItemID: 60

    "Building bridges"

    Allows Isaac to walk over gaps with a width of one tile.

      Type: Passive

      Item Pool: Shop

    * shop room pool, shop item pool, the lost item pool, brown, wooden

  • Charm of the Vampire

    ItemID: 62

    "Kills heal"

    Heals half a heart after every 13 enemies killed.

    Works with the Keeper for restoring coin HP.

      Type: Passive

      Item Pool: Item Room

    * item room, treasure room, item room pool, the lost item pool, black, grey, gray, bat

  • The Battery

    ItemID: 63

    "Stores energy"

    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.

    If playing with Afterbirth+, this item works with self-recharging items.

      Type: Passive

      Item Pool: Shop

    * shop room pool, shop item pool, pink, purple

  • Steam Sale

    ItemID: 64

    "50% off"

    Items in the shop are now -50% off.

    15c items are reduced to 7c. 5c pickups become 3c. 3c pickups become 2c.

    Has a chance to drop from the Greed miniboss fight or when bombing the shopkeeper.

    In Afterbirth, taking multiple Steam Sales will reduce all shop prices to 0 coins. This was nerfed in Afterbirth+, where it simply gives a chance to discount items with each new Steam Sale.

    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

    * shop room pool, shop item pool, red, pink, white, paper

  • Anarchist's Cookbook

    ItemID: 65

    "Summon bombs"

    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

    * library pool, library room, book room pool, item room, treasure room, item room pool, white, red, pink

  • The Hourglass

    ItemID: 66

    "Temporary enemy slowdown"

    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

    * item room, treasure room, item room pool, hour glass, hourglass, egg timer, sandbrown, glass

  • Sister Maggy

    ItemID: 67

    "Friends 'till the end"

    A familiar which follows Isaac around and shoots blood tears that deal 3.5 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

    * devil pool, devil room pool, devil deal, item room, treasure room, item room pool, red, dead, baby

  • Technology

    ItemID: 68

    "Laser tears"

    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

    * item room, treasure room, item room pool, red, wire, white, eye

  • Chocolate Milk

    ItemID: 69

    "Charge shots"

    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

    * item room, treasure room, item room pool, brown, glass, beaker, white

  • Growth Hormones

    ItemID: 70

    "DMG up + speed up"

    +1.0 Damage Up

    +0.4 Speed Up

    Counts as 1 of 3 syringe items needed towards the Spun transformation.

      Type: Passive

      Item Pool: Boss Room, Demon Beggar

    * demon beggar pool, demon judgement pool, devil beggar pool, boss room pool, boss room item, syringe, needle, injection, purple, grey, gray

  • Mini Mush

    ItemID: 71

    "Speed + range up"

    +0.3 Speed Up

    Decreases range stat by -4.25 but increases your tear height by 1.5, increasing your actual tear range.

    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

    * item room, treasure room, item room pool, mushroom, blue, spotted

  • Rosary

    ItemID: 72

    "Faith up"

    +3 Soul Hearts.

    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

    * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, the lost item pool, red, beads, grey, gray, cross

  • Cube of Meat

    ItemID: 73

    "Gotta meat em all"

    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: Unlock this item by beating Mom for the first time.

      Type: Passive

      Item Pool: None (Horsemen boss only)

    * red, box, square

  • A Quarter

    ItemID: 74

    "+25 coins"

    +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: Unlock this item by beating Mom's Heart 8 times.

      Type: Passive

      Item Pool: Item Room, Secret Room, Super Greed Miniboss

    * secret room pool, item room, treasure room, item room pool, 25, grey, gray, silver

  • PhD

    ItemID: 75

    "Better pills"

    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

    * shop room pool, shop item pool, item room, treasure room, item room pool, pink, yellow, paper

  • X-Ray Vision

    ItemID: 76

    "I've seen everything"

    Reveals the entrance to secret rooms and automatically opens the hole, removing the need for bombs to enter.

      Type: Passive

      Item Pool: Item Room

    * item room, treasure room, item room pool, xray vision, xray glasses, pink, white, black

  • My Little Unicorn

    ItemID: 77

    "Temporary badass"

    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: 6 rooms

      Item Pool: Item Room

    * item room, treasure room, item room pool, white, horn

  • Book of Revelations

    ItemID: 78

    "Reusable soul protection"

    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 (Before afterbirth this was 35% chance)

    Counts as 1 of 3 book items needed towards the Bookworm transformation.

    UNLOCK: 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

    * library pool, library room, book room pool, item room, treasure room, item room pool, the lost item pool, purple, cross

  • The Mark

    ItemID: 79

    "DMG up"

    +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

    * curse room pool, devil pool, devil room pool, devil deal, red, 666

  • The Pact

    ItemID: 80

    "DMG + tears up"

    +0.5 Damage Up.

    +0.7 Tears Up.

    +2 Soul Hearts.

    Counts as 1 of 3 evil items needed towards the Leviathan transformation.

      Type: Passive

      Item Pool: Devil Room, Curse Room

    * curse room pool, devil pool, devil room pool, devil deal, piece of paper, bloody paper, contract, red, drip

  • Dead Cat

    ItemID: 81

    "9 lives"

    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

    * curse room pool, red chest pool, red chest item pool, devil pool, devil room pool, devil deal

  • Lord of the Pit

    ItemID: 82

    "Demon wings"

    Gives Isaac demon wings and the ability to fly.

    +0.3 Speed Up

      Type: Passive

      Item Pool: Devil Room

    * devil pool, devil room pool, devil deal, the lost item pool, cross, upside down, red, black

  • The Nail

    ItemID: 83

    "Temporary demon form"

    +0.7 Damage Up.

    -0.18 Speed Down.

    +1 Soul Heart

    Gives you the ability to crush most obstacles by walking over them.

    Allows Isaac to deal 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: Unlock this item by beating the Boss Rush with Azazel.

      Type: Active

      Recharge Time: 6 rooms

      Item Pool: Devil Room

    * devil pool, devil room pool, devil deal, grey, gray, bloody

  • We Need To Go Deeper

    ItemID: 84

    "Reusable level skip"

    Spawns a trapdoor at Isaac's feet which allows him to travel to the next floor.

    The trapdoor has a 10% chance to become a Crawl Space or Black Market.

    Has no effect in Sheol, Cathedral, Chest and Dark Room.

    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

    * secret room pool, devil pool, devil room pool, devil deal, silver, grey, gray, dig, spade, shovel

  • Deck of Cards

    ItemID: 85

    "Reusable card generator"

    Gives Isaac a random tarot card on use.

      Type: Active

      Recharge Time: 6 rooms

      Item Pool: Item Room, Shop

    * shop room pool, shop item pool, item room, treasure room, item room pool, brown, pink

  • Monstro's Tooth

    ItemID: 86

    "Summon monstro"

    When used, spawns a Monstro which will jump on a random enemy in the room, dealing 120 damage and destroying nearby obstacles.

    UNLOCK: Unlock this item by beating the Basement II for the first time.

      Type: Active

      Recharge Time: 3 rooms

      Item Pool: Item Room

    * item room, treasure room, item room pool, white, grey, gray, bloody

  • Loki's Horns

    ItemID: 87

    "Cross tears"

    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 +7 Luck it will activate every time.

    UNLOCK: Unlock this item by beating Lokii for the first time.

      Type: Passive, Tear Modifier

      Item Pool: Item Room

    * item room, treasure room, item room pool, grey, gray, devil

  • Little Chubby

    ItemID: 88

    "Attack buddy"

    A familiar that follows Isaac and charges forwards, dealing 3.5 damage per tick to any enemies it comes into contact with.

    UNLOCK: Unlock this item by beating the Caves II for the first time.

      Type: Passive, Familiar

      Item Pool: Item Room

    * item room, treasure room, item room pool, yellow, smile, face, bug

  • Spider Bite

    ItemID: 89

    "Slow effect"

    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

    * item room, treasure room, item room pool, black, grey, gray, red, bug

  • The Small Rock

    ItemID: 90

    "DMG up"

    +1.0 Damage Up.

    +0.2 Tears Up.

    -0.2 Speed Down.

    Has a chance to drop when exploding a tinted rock.

    UNLOCK: Unlock this item by destroying 100 tinted rocks.

      Type: Passive

      Item Pool: None (Tinted rock only)

    * tinted rock, marked rock, grey, gray, lump, white

  • Spelunker Hat

    ItemID: 91

    "See-through doors"

    Reveals adjacent room types, 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.

      Type: Passive

      Item Pool: Item Room

    * item room, treasure room, item room pool, spelunky, miner, mining, helpmet, light, purple, olmec yama grey, gray, lamp

  • Super Bandage

    ItemID: 92

    "+2 hearts"

    +1 Health Up.

    +2 Soul Hearts

    UNLOCK: Unlock this item by making a Super Bandage Girl.

      Type: Passive

      Item Pool: Item Room, Boss Room, pink, plaster, sticker

    * boss room pool, boss room item, item room, treasure room, item room pool, the lost item pool

  • The Gamekid

    ItemID: 93

    "Temporary Man-Pac"

    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: Unlock this item by visiting 10 arcades.

      Type: Active

      Recharge Time: 6 rooms

      Item Pool: Item Room

    * item room, treasure room, item room pool, gameboy, grey, gray, white

  • Sack of Pennies

    ItemID: 94

    "Gives money"

    A bag that floats around following Isaac and drops a random coin every 2 rooms.

    UNLOCK: Unlock this item by beating Isaac with Cain.

      Type: Passive, Familiar

      Item Pool: Item Room, Secret Room

    * secret room pool, item room, treasure room, item room pool, bag, purple, pouch

  • Robo-Baby

    ItemID: 95

    "Friends till the bzzzttt"

    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.

      Type: Passive, Familiar

      Item Pool: Item Room

    * item room, treasure room, item room pool, robo baby, robot baby, white, grey, gray, silver, red

  • Little C.H.A.D.

    ItemID: 96

    "Gives kisses"

    A familiar which follows Isaac and drops half a red heart every 3 rooms.

    UNLOCK: 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

    * little chad, item room, treasure room, item room pool, the lost item pool, red, smile, face, bug

  • The Book of Sin

    ItemID: 97

    "Reusable item generator"

    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.

    Counts as 1 of 3 book items needed towards the Bookworm transformation.

    UNLOCK: Unlock this item by beating each of the Seven Sins once.

      Type: Active

      Recharge Time: 4 rooms

      Item Pool: Item Room, Library, Devil Room

    * library pool, library room, book room pool, devil pool, devil room pool, devil deal, item room, treasure room, item room pool, red 7 book, grey, gray, black

  • The Relic

    ItemID: 98

    "Soul generator"

    A blue cross that follows Isaac and drops a soul heart every 5 or 6 rooms.

    UNLOCK: Unlock this item by beating the Isaac boss with Maggy.

      Type: Passive, Familiar

      Item Pool: Item Room, Angel Room

    * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, the lost item pool

  • Little Gish

    ItemID: 99

    "Sticky friend"

    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: Unlock this item by beating the Depths 20 times and killing the Gish boss.

      Type: Passive, Familiar

      Item Pool: Item Room, Gish Boss

    * item room, treasure room, item room pool, grey, gray, yellow, eyes, face

  • Little Steven

    ItemID: 100

    "Psychic friend"

    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: Unlock this item by killing the Steven boss for the first time.

      Type: Passive, Familiar

      Item Pool: Item Room, Steven Boss

    * boss room pool, boss room item, item room, treasure room, item room pool, black, baby, white, eyes

  • The Halo

    ItemID: 101

    "All stats up"

    +1 Health Up.

    +0.3 Damage Up.

    +0.2 Tears Up.

    +0.25 Range Up.

    +0.3 Speed Up.

    +0.5 Tear Height.

    Counts as 1 of 3 angel items needed towards the Seraphim transformation.

    UNLOCK: Unlock this item by killing Mom (Mom's Foot or Mom's Heart) using The Bible.

      Type: Passive

      Item Pool: Item Room, Boss Room, Angel Room

    * angel room pool, god room pool, angel room item, boss room pool, boss room item, item room, treasure room, item room pool, yellow, golden, ring, circle

  • Mom's Bottle of Pills

    ItemID: 102

    "Reusable pill generator"

    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

    * dungeon room, blood challenge room, arena pool, demon beggar pool, demon judgement pool, devil beggar pool, normal beggar pool, normal judgement pool, coin beggar pool, coin judgement pool, shop room pool, shop item pool, item room, treasure room, item room pool, yellow, red, blue, medicine, jar, drug

  • The Common Cold

    ItemID: 103

    "Poison damage"

    Tears now have a random chance to apply a poison effect, causing double your tear damage per tick to enemies over time.

    Before Afterbirth this poison effect dealth a static 4 or 6 dmg per tick.

    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

    * item room, treasure room, item room pool, green, snot, booger, ball, slime

  • The Parasite

    ItemID: 104

    "Split shot"

    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: 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

    * item room, treasure room, item room pool, pink, slug, bug, face

  • The D6

    Special item

    ItemID: 105

    "Reroll your destiny"

    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: Unlock this item by defeating the Isaac boss with Blue Baby.

      Type: Active

      Recharge Time: 6 rooms

      Item Pool: Item Room

    * item room, treasure room, item room pool, dice pip, starting, pink, red, cube

  • Mr. Mega

    ItemID: 106

    "Blast damage"

    +5 Bombs

    Bombs now do 110 damage (up from 60) 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: Unlock this item by destroying 10 tinted rocks.

      Type: Passive

      Item Pool: Item Room, Secret Room, Super Wrath Miniboss

    * boss rush pool, boss rush room, secret room pool, item room, treasure room, item room pool, dungeon room, blood challenge room, arena pool, slackaholicus, grey, gray, face

  • Pinking Shears

    ItemID: 107

    "Cut and run"

    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: 6 rooms

      Item Pool: Item Room

    * item room, treasure room, item room pool, scissors, cutters, snip, scissors, silver, grey, gray

  • The Wafer

    ItemID: 108

    "Damage resistance"

    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

    * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, communion, the lost item pool, circle, cross, white, yellow

  • Money = Power

    ItemID: 109

    "$$$ = DMG"

    +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

    * item room, treasure room, item room pool, dollar, red, grey, gray,

  • Mom's Contacts

    ItemID: 110

    "Freeze effect"

    Tears now have a random chance to freeze enemies in place.

    The chance to freeze enemies is affected by your luck stat.

    +0.25 Range Up.

    +0.5 Tear Height.

    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: Unlock this item by collecting 3 'Mom' items in one playthrough.

      Type: Passive

      Item Pool: Item Room, Challenge Room

    * item room, treasure room, item room pool, dungeon room, blood challenge room, arena pool, pink, red, eye, glow

  • The Bean

    ItemID: 111

    "Toot on command"

    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. Before Afterbirth this was a flat 3.5 damage.

      Type: Active

      Recharge Time: 1 room.

      Item Pool: Item Room, Beggar

    * normal beggar pool, normal judgement pool, coin beggar pool, coin judgement pool, item room, treasure room, item room pool, team bean, #teambean, brown, kidney

  • Guardian Angel

    ItemID: 112

    "Extra protection"

    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.

    UNLOCK: Unlock this item by beating Satan with Maggy.

      Type: Passive, Orbital

      Item Pool: Angel Room

    * angel room pool, god room pool, angel room item, baby, wings

  • Demon Baby

    ItemID: 113

    "Auto-turret friend"

    A familiar which follows Isaac and automatically fires tears that deal 3 damage each at any enemies in close range.

    UNLOCK: Unlock this item by beating the Dark Room with Azazel.

      Type: Passive, Familiar

      Item Pool: Item Room, Devil Room

    * devil pool, devil room pool, devil deal, item room, treasure room, item room pool, dead, black, grey, gray, horns

  • Mom's Knife

    Special item

    ItemID: 114

    "Stab stab stab"

    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: Unlock this item by beating Satan with Isaac.

      Type: Passive, Tear Modifier

      Item Pool: Item Room, Devil Room, Challenge Room

    * dungeon room, blood challenge room, arena pool, devil pool, devil room pool, devil deal, item room, treasure room, item room pool, grey, gray, silver

  • Ouija Board

    ItemID: 115

    "Spectral tears"

    Gives Isaac spectral tears which allows them to travel through objects in the environment (i.e. rocks).

      Type: Passive

      Item Pool: Item Room

    * item room, treasure room, item room pool, luigi board, weeja board, paper, grown

  • 9 Volt

    ItemID: 116

    "Quicker charge"

    Automatically gives you 1 bar of charge after using your spacebar item.

    Fully recharges your current spacebar item when picked up.

    Causes the Sharp Plug item to become useless for 2+ room recharge items, due to the fact that you can never have 0 charge on your spacebar item.

    Any items which are normally a 1 room recharge are now timed instead.

      Type: Passive

      Item Pool: Shop

    * shop room pool, shop item pool, battery, black, brown

  • Dead Bird

    ItemID: 117

    "Protective buddy"

    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

    * item room, treasure room, item room pool, the lost item pool, starting, grey, gray

  • Brimstone

    Special item

    ItemID: 118

    "Blood laser barrage"

    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 (damage * 13) to any enemies it comes into contact with.

    Does not directly affect your Damage stat but hits enemies 13 times per charge, spawning Guppy flies with every hit.

    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.

    An item only found in the devil room pool (Note: The Fallen boss pulls items from the Devil Room Pool)

    Counts as 1 of 3 evil items needed towards the Leviathan transformation.

      Type: Passive, Tear Modifier

      Item Pool: Devil Room

    * devil pool, devil room pool, devil deal, infinity, red, black

  • Blood Bag

    ItemID: 119

    "HP up"

    +1 Health Up

    +0.3 Speed Up

    Heals for 5 full red hearts.

    Has a chance to drop while playing any Blood Donation machine.

    UNLOCK: Unlock this item by playing the Blood Donation machine 30 times.

      Type: Passive

      Item Pool: None (Blood Donation machine only)

    * , the lost item pool, red, white

  • Odd Mushroom (Thin)

    ItemID: 120

    "Fire rate up"

    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, brown, purple, grey, gray

    * secret room pool, item room, treasure room, item room pool

  • Odd Mushroom (Large)

    ItemID: 121

    "DMG up"

    +1 Health Up (The given heart container is empty)

    +0.3 Damage Up.

    +0.25 Range Up.

    -0.1 Speed Down.

    +0.5 Tear Height.

    Counts as 1 of 3 mushroom items needed towards the Fun Guy transformation.

      Type: Passive

      Item Pool: Item Room, Secret Room

    * secret room pool, item room, treasure room, item room pool, purple, pink, brown, thick odd mushroom thick

  • Whore of Babylon

    ItemID: 122

    "Curse up"

    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

    * devil pool, devil room pool, devil deal, red, black, star, moon

  • Monster Manual

    ItemID: 123

    "Temporary buddy generator"

    When used, gives a random familiar for the rest of the room.

    It can spawn familiars you haven't unlocked yet!

      Type: Active

      Recharge Time: 3 rooms

      Item Pool: Item Room

    * item room, treasure room, item room pool, book, brown, blue, monster manuel, manaul

  • Dead Sea Scrolls

    ItemID: 124

    "It's a mystery"

    Upon use, the dead sea scrolls gives a random spacebar item effect.

    An item that can be found in the Angel room.

      Type: Active

      Recharge Time: 2 rooms

      Item Pool: Item Room, Angel Room

    * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, paper, roll, white

  • Bobby - Bomb

    ItemID: 125

    "Friends till the end"

    +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

    * boss rush pool, boss rush room, item room, treasure room, item room pool, bomb beggar, dead, grey, gray, feet

  • Razor Blade

    ItemID: 126

    "Feel my pain"

    When used, deals damage to Isaac in exchange for +1.2 damage up which lasts for the current room.

    In Afterbirth Eve starts with this item after donating 439 coins to the Greed Donation Machine..

    UNLOCK: Unlock this item by beating Satan with Eve.

      Type: Active

      Recharge Time: Instant

      Item Pool: Devil Room

    * devil pool, devil room pool, devil deal, the lost item pool, starting, silver, grey, gray

  • Forget Me Now

    ItemID: 127

    "I don't remember..."

    Upon use, this item refreshes the current floor with brand new rooms, monsters and items, as if you had entered a new floor.

    UNLOCK: Unlock this item by beating Satan with Blue Baby.

      Type: Active

      Recharge Time: Instant (One time use)

      Item Pool: Item Room, Secret Room

    * secret room pool, item room, treasure room, item room pool, pill, tablet, drug, white, purple

  • Forever Alone

    ItemID: 128

    "Attack fly"

    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

    * item room, treasure room, item room pool, blue

  • Bucket of Lard

    ItemID: 129

    "HP up"

    +2 Health Up.

    -0.2 Speed Down.

    Of the two heart containers given from this item, only 1/2 a red heart of them is filled.

    Has a chance to drop from the Super Gluttony miniboss fight.

      Type: Passive

      Item Pool: Item Room, Super Gluttony Miniboss

    * item room, treasure room, item room pool, the lost item pool, white, grey, gray, tub

  • A Pony

    ItemID: 130

    "Flight + dash attack"

    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 40 contact damage to anything he hits.

    Drops from the Headless Horseman boss fight.

      Type: Active

      Recharge Time: 4 rooms

      Item Pool: None (Headless horseman only)

    * headless horseman, headless horsemen, red, grey, gray

  • Bomb Bag

    ItemID: 131

    "Gives bombs"

    A bag of bombs that will drop a bomb pickup every 2 rooms.

    UNLOCK: Unlock this item by beating Satan with Cain.

      Type: Passive, Familiar

      Item Pool: Item Room, Secret Room, Bomb Beggar

    * boss rush pool, boss rush room, secret room pool, item room, treasure room, item room pool, sack, pouch, blue, purple

  • A Lump of Coal

    ItemID: 132

    "My Xmas present"

    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.

    In Afterbirth this item synergises with Brimstone and Tech, allowing them to do more damage the further away the enemy is. If not playing with Afterbirth it simply gives Brimstone +2 flat damage.

      Type: Passive

      Item Pool: None (Krampus only)

    * krampus, grey, gray

  • Guppy's Paw

    ItemID: 133

    "Soul converter"

    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

    * curse room pool, red chest pool, red chest item pool, devil pool, devil room pool, devil deal, the lost item pool, cat, bone, pink, grey, gray

  • Guppy's Tail

    ItemID: 134

    "Cursed?"

    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

    * curse room pool, red chest pool, red chest item pool, devil pool, devil room pool, devil deal, black, white, gray, grey

  • IV Bag

    ItemID: 135

    "Portable blood bank"

    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)

    * , the lost item pool, red, white

  • Best Friend

    ItemID: 136

    "Friends 'till the end"

    Places a decoy on the floor which attracts enemies and explodes after a period of time.

    When it explodes, it deals 110 damage to everything in radius (Same damage as Mr Mega bombs).

      Type: Active

      Recharge Time: 3 rooms.

      Item Pool: Item Room

    * item room, treasure room, item room pool, worst friend, dead, baby, pink

  • Remote Detonator

    ItemID: 137

    "Remote bomb detonation"

    +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

    * boss rush pool, boss rush room, shop room pool, shop item pool, item room, treasure room, item room pool, red, boom, tnt

  • Stigmata

    ItemID: 138

    "DMG + HP up"

    +1 Health Up.

    +0.3 Damage Up.

      Type: Passive

      Item Pool: Item Room

    * item room, treasure room, item room pool, wooden, cross, brown

  • Mom's Purse

    ItemID: 139

    "More trinket room"

    Isaac can now hold two trinkets at the same time

    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

    * shop room pool, shop item pool, purple, pink, bag

  • Bob's Curse

    ItemID: 140

    "Poison bombs"

    All of Isaac's bombs now leave a poison effect on any enemies within the blast radius.

    +5 Bombs.

    As well as dealing the standard 60 damage for a bomb, it will apply a Damage over Time effect that does 4 or 6 damage per tick.

    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

    * boss rush pool, boss rush room, item room, treasure room, item room pool, bob sloth, bomb beggar, green, dead, face

  • Pageant Boy

    ItemID: 141

    "Ultimate grand supreme"

    Spawns 7 random coins around Isaac on the floor.

    Isaac wears a pink crown on his head.

      Type: Passive

      Item Pool: Boss Room

    * boss room pool, boss room item, dtQt, dtphase, crown, nocrown, yescrown, diana, princezzxdiana, pink, purple, hat

  • Scapular

    ItemID: 142

    "You have been blessed"

    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.

      Type: Passive

      Item Pool: Item Room, Angel Room

    * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, the lost item pool, brown, white, cross

  • Speed Ball

    ItemID: 143

    "Speed + shot speed up"

    +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

    * demon beggar pool, demon judgement pool, devil beggar pool, boss room pool, boss room item, item room, treasure room, item room pool, syringe, needle, injection, white

  • Bum Friend

    ItemID: 144

    "He's Greedy"

    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 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.

    Counts as 1 of 3 bum items needed towards the Super Bum transformation.

      Type: Passive, Familiar

      Item Pool: Item Room

    * item room, treasure room, item room pool, baby, pink

  • Guppy's Head

    ItemID: 145

    "Reusable fly hive"

    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 Chest

    * curse room pool, red chest pool, red chest item pool, golden chest pool, gold chest pool, devil pool, devil room pool, devil deal, dead, cat, grey, gray

  • Prayer Card

    ItemID: 146

    "Reusable eternity"

    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

    * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, the lost item pool, white, yellow, blue

  • Notched Axe

    ItemID: 147

    "Rocks didn't stand a chance"

    Each charge of this item allows Isaac to break all rocks, pots and secret room doors in the current room.

    Cannot break the stone blocks which appear in the environment.

    If Isaac is damaged while the effect is active, it will deactivate.

      Type: Active

      Recharge Time: 3 rooms

      Item Pool: Item Room

    * item room, treasure room, item room pool, minecraft, brown, grey, gray, silver

  • Infestation

    ItemID: 148

    "They grow inside"

    When Isaac gets hit, 1-3 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

    * item room, treasure room, item room pool, the lost item pool, bug, yellow, face

  • Ipecac

    ItemID: 149

    "Explosive shots"

    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).

    +13.0 Tear Height.

    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: Unlock this item by beating Mom's Heart 6 times.

      Type: Passive, Tear Modifier

      Item Pool: Item Room

    * item room, treasure room, item room pool, jar, bottle, purple, label

  • Tough Love

    ItemID: 150

    "Tooth shot"

    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

    * item room, treasure room, item room pool, knuckle, dusters, four, silver, grey, gray

  • The Mulligan

    ItemID: 151

    "They grow inside"

    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

    * item room, treasure room, item room pool, heart

  • Technology 2

    ItemID: 152

    "Laser"

    Isaac now also has a laser with unlimited range which fires continuously and does damage very rapidly.

    -35% Damage Down (0.65 damage multiplier).

    The laser can apply status effects (e.g. Poison) rapidly due to how often it hits.

      Type: Passive, Tear Modifier

      Item Pool: Item Room

    * item room, treasure room, item room pool, silver, gray, grey, red, machine

  • Mutant Spider

    Special item

    ItemID: 153

    "Quad Shot"

    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

    * item room, treasure room, item room pool, green, black

  • Chemical Peel

    ItemID: 154

    "DMG up"

    +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

    * item room, treasure room, item room pool, poison, green, brown, bottle, jar, danger

  • The Peeper

    ItemID: 155

    "Plop!"

    Gives Isaac an eye companion that floats around the room and deals 8 damage per tick on contact with enemies.

      Type: Passive, Familiar

      Item Pool: Item Room

    * item room, treasure room, item room pool, red, white

  • Habit

    ItemID: 156

    "Item martyr"

    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

    * angel room pool, god room pool, angel room item, shop room pool, shop item pool, the lost item pool, white, black

  • Bloody Lust

    ItemID: 157

    "RAGE!"

    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, +0.5, +0.5, +33%, +33%, +33%.

    The maximum effect is (damage + 1.5) * 2, resulting in more than double your original damage and stacking with other damage increasing items.

    Samson starts with this item.

    UNLOCK: Unlock this item by beating the Isaac boss with Samson.

      Type: Passive

      Item Pool: Item Room

    * item room, treasure room, item room pool, the lost item pool, starting, red, blood, drop

  • Crystal Ball

    ItemID: 158

    "I see my future"

    Upon use, reveals the map and gives the player a random tarot card, mystic rune or soul heart.

    Does not reveal the location of Secret or Super Secret rooms.

    Has a chance to drop from playing a fortune machine.

      Type: Active

      Recharge Time: 6 rooms

      Item Pool: Item Room

    * item room, treasure room, item room pool, white, purple

  • Spirit of the Night

    ItemID: 159

    "Scary"

    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

    * devil pool, devil room pool, devil deal, red, crescent, moon, drop, black

  • Crack The Sky

    ItemID: 160

    "Holy white death"

    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.

    In Afterbirth, the beams now have improved targetting and have a high chance to spawn on top of enemies where possible.

      Type: Active

      Recharge Time: 4 rooms

      Item Pool: Item Room

    * item room, treasure room, item room pool, feather, white, arrow

  • Ankh

    ItemID: 161

    "Eternal life?"

    Upon death, the player respawns 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

    * item room, treasure room, item room pool, black, grey, gray, extra life, egypt, grey, gray

  • Celtic Cross

    ItemID: 162

    "You feel blessed"

    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.

    UNLOCK: Unlock this item by beating the Chest with Maggy.

      Type: Passive

      Item Pool: Item Room, Angel Room

    * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, the lost item pool, grey, gray

  • Ghost Baby

    ItemID: 163

    "Spectral buddy"

    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.

      Type: Passive, Familiar

      Item Pool: Item Room, Devil Room

    * devil pool, devil room pool, devil deal, item room, treasure room, item room pool, white, spoopy

  • The Candle

    ItemID: 164

    "Reusable flame"

    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: Unlock this item by donating 900 coins to the Shop.

      Type: Active

      Recharge Time: Timed (A few seconds)

      Item Pool: Shop

    * shop room pool, shop item pool, blue candle, grey, gray, silver, lamp, lantern

  • Cat-O-Nine-Tails

    ItemID: 165

    "Shot speed up + DMG up"

    +1.0 Damage Up.

    +0.23 Shot Speed Up.

    An item only found in the Boss room pool.

      Type: Passive

      Item Pool: Boss Room

    * boss room pool, boss room item, grey, gray, whip

  • D20

    ItemID: 166

    "Reroll the basics"

    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: Unlock this item by beating the Chest with Isaac.

      Type: Active

      Recharge Time: 6 rooms

      Item Pool: Item Room

    * item room, treasure room, item room pool, dice pip, red

  • Harlequin Baby

    ItemID: 167

    "Double shot buddy"

    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

    * item room, treasure room, item room pool, bug, eyes, pink, red

  • Epic Fetus

    Special item

    ItemID: 168

    "On-demand air strike"

    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: Unlock this item by beating Challenge #19 (The Family Man).

      Type: Passive, Tear Modifier

      Item Pool: Item Room

    * item room, treasure room, item room pool, fetus in a jar, bug, white, hat, pink

  • Polyphemus

    Special item

    ItemID: 169

    "Mega tears"

    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

    * item room, treasure room, item room pool, large eye, cyclops, one eye, blue, white

  • Daddy Longlegs

    ItemID: 170

    "Daddy's love"

    A shadow follows Isaac and stomps on enemies randomly, dealing 40 damage per stomp (2 damage ticks at 20 damage each).

      Type: Passive, Familiar

      Item Pool: Item Room

    * item room, treasure room, item room pool, white, yarn, wool, spider

  • Spider Butt

    ItemID: 171

    "Mass enemy slowdown + damage"

    Upon use, does 10 damage to all enemies in the room and gives them a slowing effect for 4 seconds.

    Counts as 1 of 3 spider items needed towards the Spider Baby transformation.

      Type: Active

      Recharge Time: 2 rooms

      Item Pool: Item Room

    * item room, treasure room, item room pool, brown, red, web

  • Sacrificial Dagger

    ItemID: 172

    "My fate protects me"

    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: Unlock this item by beating the Chest with Eve.

      Type: Passive, Orbital

      Item Pool: Item Room, Devil Room

    * devil pool, devil room pool, devil deal, item room, treasure room, item room pool, bloody, knife, red, silver

  • Mitre

    ItemID: 173

    "You feel blessed"

    Gives a 50% 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

    * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, the lost item pool, gold, orange, yellow, cross, pope, hat

  • Rainbow Baby

    ItemID: 174

    "Random buddy"

    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.

      Type: Passive, Familiar

      Item Pool: Item Room

    * item room, treasure room, item room pool, purple

  • Dad's Key

    ItemID: 175

    "Opens all doors..."

    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: 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

    * key master pool, key beggar pool, key judgement pool, item room, treasure room, item room pool, brown, brass, copper

  • Stem Cells

    ItemID: 176

    "HP up"

    +1 Health Up.

    +0.16 Shot Speed Up.

      Type: Passive

      Item Pool: Item Room, Boss Room

    * boss room pool, boss room item, item room, treasure room, item room pool, lumpy, red, balls

  • Portable Slot

    ItemID: 177

    "Gamble 24/7"

    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

    * normal beggar pool, normal judgement pool, coin beggar pool, coin judgement pool, shop room pool, shop item pool,red, robot, head, cube

  • Holy Water

    ItemID: 178

    "Splash!"

    When Isaac takes damage, the bottle breaks and leaves a pool on the floor which deals 8 damage per tick to enemies which walk over it.

      Type: Passive, Familiar

      Item Pool: Item Room, Angel Room

    * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, the lost item pool, white, blue, cross, jar

  • Fate

    ItemID: 179

    "Flight eternal"

    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: Unlock this item by beating the Chest with Blue Baby.

      Type: Passive

      Item Pool: Gold Chest

    * golden chest pool, gold chest pool, blue head, the lost item pool, dead, ball

  • The Black Bean

    ItemID: 180

    "Toot on touch"

    Upon taking damage, Isaac will fart, causing all enemies in close proximity to become poisoned.

    Black Bean deals your tear damage for 6 ticks. Before Afterbirth this was a flat 5 damage per tick.

      Type: Passive

      Item Pool: Item Room, Beggar

    * normal beggar pool, normal judgement pool, coin beggar pool, coin judgement pool, item room, treasure room, item room pool, the lost item pool, kidney, grey, gray

  • White Pony

    ItemID: 181

    "Flight + holy death"

    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 also casting the effect of Crack The Sky.

    The charge of the spacebar attack deals 40 damage on contact with enemies and the beams deal damage equal to your tear damage + 20.

    Drops from the Conquest boss fight.

      Type: Active

      Recharge Time: 6 rooms

      Item Pool: None (Conquest boss only)

    *, red, horse, head

  • Sacred Heart

    Special item

    ItemID: 182

    "Homing shots + DMG up"

    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.

    +4.125 Range Up.

    +0.75 Tear Height.

    Full red heart heal.

      Type: Passive, Tear Modifier

      Item Pool: Angel Room

    * angel room pool, god room pool, angel room item, red, fire, flame, orange, cross

  • Toothpicks

    ItemID: 183

    "Tears + shot speed up"

    +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

    * boss room pool, boss room item, sticks, brown, yellow

  • Holy Grail

    ItemID: 184

    "Flight + HP up"

    +1 Health Up

    Gives Isaac the ability to fly.

    Counts as 1 of 3 angel items needed towards the Seraphim transformation.

      Type: Passive

      Item Pool: Angel Room

    * angel room pool, god room pool, angel room item, the lost item pool, cup, wooden, gold, chalice, indiana jones

  • Dead Dove

    ItemID: 185

    "Flight + spectral tears"

    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

    * angel room pool, god room pool, angel room item, bird, white

  • Blood Rights

    ItemID: 186

    "Mass enemy damage at a cost"

    Upon use, takes away one full heart and deals 40 damage to the entire room.

    With the Isaac's Heart item, you can use Blood Rights without taking damage.

    UNLOCK: Unlock this item by beating Satan with Samson.

      Type: Active

      Recharge Time: Instant.

      Item Pool: Item Room

    * item room, treasure room, item room pool, razor, straight, edge, barber, bloody, brown, silver

  • Guppy's Hairball

    ItemID: 187

    "Swing it"

    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

    * devil pool, devil room pool, devil deal, grey, brown, pile

  • Abel

    ItemID: 188

    "Mirrored buddy"

    A familiar that mirrors the player's movements and shoots tears directly at Isaac.

    Abel's tears do the same as Isaac's base damage (3.5).

    In larger rooms, Abel will mirror to the other side of the screen instead of the entire room.

    UNLOCK: Unlock this item by beating the Dark Room with Cain.

      Type: Passive, Familiar

      Item Pool: Item Room, Gold Chest

    * golden chest pool, gold chest pool, item room, treasure room, item room pool, follower, everyone knows it's abel, brown, grey, gray, dead, head, grey, green

  • SMB Super Fan

    ItemID: 189

    "All stats up"

    Isaac turns red like Meatboy.

    +1 Health Up.

    +0.3 Damage Up.

    +0.2 Tears Up.

    +0.5 Range Up.

    +0.2 Speed Up.

    +1.0 Tear Height.

    Full red heart heal.

    UNLOCK: Unlock this item by beating Challenge #14 (It's in the Cards).

      Type: Passive

      Item Pool: Item Room

    * item room, treasure room, item room pool, bloody, silver, grey, gray, sharp

  • Pyro

    ItemID: 190

    "99 bombs"

    Gives Isaac 99 bombs.

      Type: Passive

      Item Pool: Item Room, Secret Room, Bomb Beggar

    * secret room pool, item room, treasure room, item room pool, smile, face, grinning, doitfgt

  • 3 Dollar Bill

    ItemID: 191

    "Rainbow tears"

    Grants Isaac random tear effects.

    Possible tear effects: 20/20, Ball of Tar, Dark Matter, Death's Touch, Fire Mind, Iron Bar, Mom's Contacts, My Reflection, Mysterious Liquid, Number One, Ouija Board, Proptosis, Sagittarius, Scorpio, Speed Ball, Spoon Bender, The Inner Eye, Tough Love.

    The tear type changes every few seconds. Before Afterbirth the tear effect changed for each room.

      Type: Passive, Tear Modifier

      Item Pool: Item Room

    * item room, treasure room, item room pool, pink note, money, cash, three dollar bill, cash money

  • Telepathy for Dummies

    ItemID: 192

    "Temporary psychic shot"

    When used, Isaac gains homing shots for the current room.

    Counts as 1 of 3 book items needed towards the Bookworm transformation.

      Type: Active

      Recharge Time: 2 rooms

      Item Pool: Item Room, Library

    * library pool, library room, book room pool, item room, treasure room, item room pool, yellow book how to

  • MEAT!

    ItemID: 193

    "DMG + HP up"

    +1 Health Up.

    +0.3 Damage Up.

      Type: Passive

      Item Pool: Boss Room

    * boss room pool, boss room item, bone, red, brown

  • Magic 8 Ball

    ItemID: 194

    "Shot speed up"

    +0.16 Shot Speed Up.

    Gives Isaac a random tarot card when picked up.

      Type: Passive

      Item Pool: Boss Room

    * boss room pool, boss room item, eight, grey, gray

  • Mom's Coin Purse

    ItemID: 195

    "What's all this...?"

    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

    * dungeon room, blood challenge room, arena pool, demon beggar pool, demon judgement pool, devil beggar pool, normal beggar pool, normal judgement pool, coin beggar pool, coin judgement pool, boss room pool, boss room item, shop room pool, shop item pool, bag, pouch

  • Squeezy

    ItemID: 196

    "Tears up"

    +2 Soul Hearts.

    +0.4 Tears Up.

      Type: Passive

      Item Pool: Boss Room

    * boss room pool, boss room item, mr. squeezy, mr squeezy, cobaltstreak, white, brown, red, bow,

  • Jesus Juice

    ItemID: 197

    "Damage + range up"

    +0.5 Damage Up.

    +0.25 Range Up.

    +0.5 Tear Height.

      Type: Passive

      Item Pool: Boss Room

    * boss room pool, boss room item, purple, carton, grape drank

  • Box

    ItemID: 198

    "Stuff"

    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

    * dungeon room, blood challenge room, arena pool, normal beggar pool, normal judgement pool, coin beggar pool, coin judgement pool, boss room pool, boss room item, brown, orange, cardboard

  • Mom's Key

    ItemID: 199

    "Less is more now +2 keys"

    +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

    * key master pool, key beggar pool, key judgement pool, , dungeon room, blood challenge room, arena pool, shop room pool, shop item pool, golden, horns

  • Mom's Eyeshadow

    ItemID: 200

    "Charm tears"

    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

    * dungeon room, blood challenge room, arena pool, item room, treasure room, item room pool, grey, gray, blue

  • Iron Bar

    ItemID: 201

    "Concussive tears"

    +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

    * item room, treasure room, item room pool, grey, gray, silver, ingot

  • Midas Touch

    ItemID: 202

    "Golden touch"

    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

    * item room, treasure room, item room pool, gold, ingot, bar, orange

  • Humbling Bundle

    ItemID: 203

    "1+1free 4evar!"

    All future pennies, keys, bombs and hearts will drop in pairs.

    Does not work for other pickups, such as soul hearts, nickels, dimes, cards, pills etc.

      Type: Passive

      Item Pool: Shop

    * Humbleing bundle shop room pool, shop item pool, paper, purple, brown

  • Fanny pack

    ItemID: 204

    "Filled with goodies"

    When you take damage, there is a 50% chance to drop a random heart, key, bomb or coin.

      Type: Passive

      Item Pool: Shop, Beggar

    * normal beggar pool, normal judgement pool, coin beggar pool, coin judgement pool, shop room pool, shop item pool, bag, satchel, backpack, purse, satchel, brown

  • Sharp plug

    ItemID: 205

    "Charge with blood"

    When your spacebar item is out of charge, you can press spacebar to recharge it at the cost of 2 health.

    Can't be used if your spacebar item has any number of charges on it.

    This item only costs 1/2 a heart to use if you have The Wafer item.

    The Sharp Plug will take health from Soul/Black hearts (if any) before taking red hearts.

      Type: Passive

      Item Pool: Shop

    * shop room pool, shop item pool, the lost item pool, white,

  • The Guillotine

    ItemID: 206

    "An out-of-body experience"

    +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: Unlock this item by beating the Isaac boss with Judas.

      Type: Passive

      Item Pool: Item Room

    * item room, treasure room, item room pool, chop, head, silver, metal

  • Ball of Bandages

    ItemID: 207

    "Gotta lick em all"

    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)

    * super meat boy, pink, plasters

  • Champion Belt

    ItemID: 208

    "DMG + Challenge up"

    +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

    * shop room pool, shop item pool, red, croissant, crescent

  • Butt Bombs

    ItemID: 209

    "Toxic blast +5 bombs"

    +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.

      Type: Passive

      Item Pool: Item Room, Bomb Beggar

    * boss rush pool, boss rush room, item room, treasure room, item room pool, poop, face, brown

  • Gnawed Leaf

    ItemID: 210

    "Unbreakable"

    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

    * item room, treasure room, item room pool, raccoon, green

  • Spider Baby

    ItemID: 211

    "Spider revenge"

    Spawns 1-2 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

    * item room, treasure room, item room pool, the lost item pool, purple, blue, heart, cute spiderbaby

  • Guppy's Collar

    ItemID: 212

    "Eternal life?"

    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

    * curse room pool, red chest pool, red chest item pool, devil pool, devil room pool, devil deal, purple, pink, circle

  • Lost Contact

    ItemID: 213

    "Shielded tears"

    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.

    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

    * secret room pool, item room, treasure room, item room pool, white, lump, oval

  • Anemic

    ItemID: 214

    "Toxic blood"

    +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

    * item room, treasure room, item room pool, blood drop, red blood, drip

  • Goat Head

    ItemID: 215

    "He accepts your offering"

    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, Red Chest, Golden Chest

    * curse room pool, red chest pool, red chest item pool, golden chest pool, gold chest pool, devil pool, devil room pool, devil deal, brown, horns

  • Ceremonial Robes

    ItemID: 216

    "Sin up"

    +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

    * curse room pool, demon beggar pool, demon judgement pool, devil beggar pool, devil pool, devil room pool, devil deal, grey, gray, hood

  • Mom's Wig

    ItemID: 217

    "You feel itchy"

    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

    * dungeon room, blood challenge room, arena pool, item room, treasure room, item room pool, orange,

  • Placenta

    ItemID: 218

    "HP up + regen"

    +1 Health Up.

    Gives a chance to heal 1/2 a red heart every 60 seconds.

    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

    * boss room pool, boss room item, the lost item pool, purple, red, lump

  • Old Bandage

    ItemID: 219

    "HP up"

    +1 Health 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

    * boss room pool, boss room item, the lost item pool, plasters, white

  • Sad Bombs

    ItemID: 220

    "Tear blast +5 bombs"

    +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

    * boss rush pool, boss rush room, item room, treasure room, item room pool, crying, face

  • Rubber Cement

    ItemID: 221

    "Bouncing tears"

    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: Unlock this item by beating Mom's heart 2 times.

      Type: Passive

      Item Pool: Item Room, Greed Mode Item Room

    * item room, treasure room, item room pool, orange, brown, bottle, jar

  • Anti-Gravity

    ItemID: 222

    "Antigravity tears + tears up"

    -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

    * anti gravity, item room, treasure room, item room pool, anti gravity, atom, nucleus

  • Pyromaniac

    Special item

    ItemID: 223

    "Hurts so good +5 bombs"

    +5 Bombs

    All explosions now heal Isaac for 1 heart instead of hurting him.

    Isaac will also be immune to other sources such as Mom's leg stomp, Satan's leg stomp.

      Type: Passive

      Item Pool: Item Room

    * item room, treasure room, item room pool, fire, heart, orange, burning, stannis

  • Cricket's Body

    ItemID: 224

    "Splash damage + tears up"

    -1 Tear Delay (Tears Up).

    -10.0 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

    * item room, treasure room, item room pool, brown, orange, headless

  • Gimpy

    ItemID: 225

    "Sweet suffering"

    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

    * curse room pool, demon beggar pool, demon judgement pool, devil beggar pool devil pool, devil room pool, devil deal, item room, treasure room, item room pool, gimp mask, the lost item pool, grey, gray, black

  • Black Lotus

    ItemID: 226

    "HP up x3"

    +1 Health Up.

    +1 Soul Heart.

    +1 Black Heart.

    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

    * secret room pool, , the lost item pool, purple, black, grey, gray, flower, mtg magic the gathering, vintage

  • Piggy Bank

    ItemID: 227

    "My life savings"

    +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

    * shop room pool, shop item pool, item room, treasure room, item room pool, pink, oink

  • Mom's Perfume:

    ItemID: 228

    "Fear shot"

    -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

    * dungeon room, blood challenge room, arena pool, item room, treasure room, item room pool, spray, brown, white, yellow

  • Monstro's Lung

    ItemID: 229

    "Charged attack"

    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

    * item room, treasure room, item room pool, pink, body part

  • Abaddon

    ItemID: 230

    "Evil up + DMG up + fear shot"

    On pickup removes all of your red hearts and gives you 6 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.

    UNLOCK: Unlock this item by beating the Chest with Azazel.

      Type: Passive

      Item Pool: Devil Room

    * devil pool, devil room pool, devil deal, red devil sign, abandon, abadon, pentagram

  • Ball of Tar

    ItemID: 231

    "Sticky feet..."

    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

    * item room, treasure room, item room pool, black, grey, gray

  • Stop Watch

    ItemID: 232

    "Let's slow this down a bit"

    +0.3 Speed Up.

    After you get hit the Stop Watch applies a slowing effect for the rest of the room to all enemies and their projectiles.

    The effect will still activate when hit while the Holy Mantle effect is active.

    The slowing effect has a reduced effect against Brimstone lasers fired by enemies.

    UNLOCK: Unlock this item by donating 999 pennies to the Shop.

    * This used to be a 'special' item in Rebirth that was permanently active, however was downgraded in Afterbirth and onwards.

      Type: Passive

      Item Pool: Shop

    * shop room pool, shop item pool, stopwatch, blue, pocket, clock

  • Tiny Planet

    ItemID: 233

    "Orbiting tears + range up"

    +7.0 Tear Height.

    Range greatly increased.

    Tears now revolve around Isaac's Body at a fixed distance until they hit the ground.

    Aiming in the opposite direction is often better due to how the tears circle around Isaac.

    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

    * item room, treasure room, item room pool, grey, gray, asteroid, silver, ball

  • Infestation 2

    ItemID: 234

    "Infestation shot"

    Creates a friendly blue spider when you kill an enemy.

    Spiders are spawned at the location where the enemy died.

      Type: Passive

      Item Pool: Item Room

    * item room, treasure room, item room pool, pink, smile

  • E. Coli

    ItemID: 236

    "Turdy Touch"

    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

    * e coli, item room, treasure room, item room pool, tampon, bloody, red, white

  • Death's Touch

    ItemID: 237

    "Penetrative shots + DMG up"

    +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: Unlock this item by beating Challenge #17 (Waka Waka).

      Type: Passive, Tear Modifier

      Item Pool: Item Room, Devil Room

    * devil pool, devil room pool, devil deal, item room, treasure room, item room pool, axe, silver, grey, gray

  • Key Piece #1

    ItemID: 238

    "???"

    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)

    * angel room, angels, broken, yellow, gold, circle

  • Key Piece #2

    ItemID: 239

    "???"

    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)

    *, yellow, gold, broken

  • Experimental Treatment

    ItemID: 240

    "All stats up! ... and then shuffled"

    Randomly increases 4 of your stats, and decreases 2 of them

    Possible stat changes are fixed values: ±1 health, ±1 damage, ±0.2 speed, ±0.5 range, ±0.5 tears, ±0.2 shot speed, ±1 luck.

    Pre-afterbirth this increased 1 stat, and decreased 1-3 stats.

    Counts as 1 of 3 syringe items needed towards the Spun transformation.

    UNLOCK: Unlock this item by beating Mom's Heart 7 times.

      Type: Passive

      Item Pool: Item Room, Boss Room, Demon Beggar

    * demon beggar pool, demon judgement pool, devil beggar pool, boss room pool, boss room item, item room, treasure room, item room pool, yellow syringe, needle, injection

  • Contract From Below

    ItemID: 241

    "Wealth, but at what cost?"

    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

    * curse room pool, demon beggar pool, demon judgement pool, devil beggar pool, devil pool, devil room pool, devil deal, paper, pink, brown, isaac

  • Infamy

    ItemID: 242

    "Blocks damage... sometimes"

    Gives a 50% chance to not take damage from projectiles.

      Type: Passive

      Item Pool: Item Room, Gold Chest, Secret Room

    * golden chest pool, gold chest pool, secret room pool, item room, treasure room, item room pool, purple, pink, mask, face

  • Trinity Shield

    ItemID: 243

    "You feel guarded"

    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

    * angel room pool, god room pool, angel room item, blue, silver, metal

  • Tech.5

    ItemID: 244

    "It's still being tested"

    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: Unlock this item by beating Challenge #18 (The Host).

      Type: Passive, Tear Modifier

      Item Pool: Item Room

    * technology.5, item room, treasure room, item room pool, white, red, eye, robot

  • 20/20

    ItemID: 245

    "Double shot"

    Isaac now shoots two tears at once.

    Unlike the Inner Eye and Mutant Spider items, this double shot item does not give a tears down, effectively giving you double damage per second potential.

      Type: Passive, Tear Modifier

      Item Pool: Item Room

    * 20 20, 2020, item room, treasure room, item room pool, black glasses, spectacles

  • Blue Map

    ItemID: 246

    "Secrets"

    Reveals the locations of the secret and super secret room for the current floor and all future floors.

    UNLOCK: Unlock this item by donating 10 pennies to the Shop.

      Type: Passive

      Item Pool: Shop, Beggar, Key Beggar

    * normal beggar pool, normal judgement pool, coin beggar pool, coin judgement pool, shop room pool, shop item pool, x, paper

  • BFFS!

    ItemID: 247

    "Your friends rule!"

    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

    * key master pool, key beggar pool, key judgement pool, shop room pool, shop item pool, red, heart, arrow

  • Hive Mind

    ItemID: 248

    "Giant spiders and flies"

    Causes your friendly blue spiders and flies to become bigger and do 2x more damage.

    Allows Mom's Wig to spawn a maximum of 10 spiders at once instead of 5.

    Counts as 1 of 3 fly items needed towards the Beelzebub transformation.

      Type: Passive

      Item Pool: Shop

    * shop room pool, shop item pool, blue, fat

  • There's Options

    ItemID: 249

    "More options"

    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: Unlock this item by donating 50 pennies to the Shop.

      Type: Passive

      Item Pool: Shop

    * shop room pool, shop item pool, white, question mark, square

  • Bogo Bombs

    ItemID: 250

    "1+1 bombs"

    All bomb pickups are now 1+1 bombs.

    An item only found in the Shop item pool.

      Type: Passive

      Item Pool: Shop, Bomb Beggar

    * shop room pool, shop item pool, purple, paper, ticket

  • Starter Deck

    ItemID: 251

    "Extra card room"

    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

    * shop room pool, shop item pool, packet, deck, brown, orange

  • Little Baggy

    ItemID: 252

    "Extra pill room"

    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: 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

    * shop room pool, shop item pool, brown, purple

  • Magic Scab

    ItemID: 253

    "HP + luck up"

    +1 Health Up.

    +1.0 Luck Up.

      Type: Passive

      Item Pool: Boss Room

    * boss room pool, boss room item, red, wedge, purple, triangle

  • Blood Clot

    ItemID: 254

    "DMG + range up"

    +1.0 Damage Up (Left eye only).

    +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

    * boss room pool, boss room item, red, blob, circle, spot

  • Screw

    ItemID: 255

    "Tears + shot speed up"

    +0.5 Tears Up

    +0.2 Shot Speed Up

      Type: Passive

      Item Pool: Boss Room

    * boss room pool, boss room item, grey, gray

  • Hot Bombs

    ItemID: 256

    "Burning blast +5 bombs"

    +5 Bombs

    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

    * item room, treasure room, item room pool, fire, orange, flame, face

  • Fire Mind

    ItemID: 257

    "Flaming tears"

    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

    * item room, treasure room, item room pool, fire, flame, orange, back, ball, burning

  • Missing No.

    ItemID: 258

    "Syntax error"

    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: Unlock this item by beating Boss Rush with Lazarus.

      Type: Passive

      Item Pool: Secret Room

    * secret room pool, mondrian, painting, yellow, blue, red, white

  • Dark Matter

    ItemID: 259

    "Fear shot"

    +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

    * devil pool, devil room pool, devil deal, grey, gray, fist, glow

  • Black Candle

    ItemID: 260

    "Curse of immunity + evil up"

    +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: Unlock this item by donating 150 pennies to the Shop.

      Type: Passive

      Item Pool: Shop, Curse Room

    * curse room pool, shop room pool, shop item pool, grey, gray

  • Proptosis

    ItemID: 261

    "Short range mega tears"

    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 double (+100%) and decreases over range to roughly (+30%).

    Despite the very small tears visually, Proptosis is always a damage up at any range for tears. However with lasers such as Brimstone this point is no longer true.

      Type: Passive, Tear Modifier

      Item Pool: Item Room

    * item room, treasure room, item room pool, red, bloody, eyeball

  • Missing Page 2

    ItemID: 262

    "Evil up + your enemies will pay"

    +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.

      Type: Passive

      Item Pool: Devil Room, Demon Beggar, Secret Room

    * demon beggar pool, demon judgement pool, devil beggar pool, secret room pool, devil pool, devil room pool, devil deal, the lost item pool, red, bloody, purple, paper

  • Smart Fly

    ItemID: 264

    "Revenge fly"

    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

    * key master pool, key beggar pool, key judgement pool, item room, treasure room, item room pool, golden, yellow, glow

  • Dry Baby

    ItemID: 265

    "Immortal friend"

    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.

      Type: Passive, Familiar

      Item Pool: Item Room

    * item room, treasure room, item room pool, dry baby is best baby, northernlion, fat skeleton, white, grey, gray

  • Juicy Sack

    ItemID: 266

    "Sticky babies"

    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 2.5x of Isaac's damage.

      Type: Passive, Familiar

      Item Pool: Item Room

    * item room, treasure room, item room pool, white, ball, dripping

  • Robo-Baby 2.0

    ItemID: 267

    "We worked out all the kinks"

    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.

    UNLOCK: Unlock this item by beating Challenge #16 (Computer Savvy).

      Type: Passive, Familiar

      Item Pool: Item Room

    * robo baby 2.0, item room, treasure room, item room pool, red, eyes, grey, gray, robot

  • Rotten Baby

    ItemID: 268

    "Infested friend"

    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

    * devil pool, devil room pool, devil deal, item room, treasure room, item room pool, dead, baby, green, red, bloody

  • Headless Baby

    ItemID: 269

    "Bloody friend"

    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

    * devil pool, devil room pool, devil deal, item room, treasure room, item room pool, bloody, red, pink, purple

  • Leech

    ItemID: 270

    "Blood sucker"

    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

    * item room, treasure room, item room pool, grey, gray, worm

  • Mystery Sack

    ItemID: 271

    "?"

    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: Unlock this item by beating the Dark Room with Eden.

      Type: Passive, Familiar

      Item Pool: Item Room, Beggar, Secret Room

    * normal beggar pool, normal judgement pool, coin beggar pool, coin judgement pool, secret room pool, item room, treasure room, item room pool, mysterious sack, multiple sacks, bag, pouch, purple, question mark

  • BBF

    ItemID: 272

    "Big beautiful fly"

    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

    * item room, treasure room, item room pool, heart, smile

  • Bob's Brain

    ItemID: 273

    "Explosive thoughts"

    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 60 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, Gold Chest

    * golden chest pool, gold chest pool, item room, treasure room, item room pool, green, ball, bad damage

  • Best Bud

    ItemID: 274

    "Sworn protector"

    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 5 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

    * key master pool, key beggar pool, key judgement pool, item room, treasure room, item room pool, the lost item pool, white

  • Lil Brimstone

    ItemID: 275

    "Evil friend"

    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 3.5 damage per tick, up to 9 times for a total of 31.5 damage.

    A familiar found in the devil room.

    * This used to be a 'special' item in Rebirth, however was downgraded in Afterbirth and onwards

      Type: Passive, Familiar

      Item Pool: Item Room, Devil Room

    * devil pool, devil room pool, devil deal, item room, treasure room, item room pool, horns, baby, smile, lil' brimstone

  • Isaac's Heart

    ItemID: 276

    "Protect it"

    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.

    Most enemies will target the heart over Isaac himself.

    Blood donation machines and devil beggars can be used for free. Spikes and Curse Rooms no longer deal damage.

    Sharp Plug becomes useless with this item, due to how damage is prevented on Isaac's body.

    UNLOCK: Unlock this item by beating the Isaac boss with The Lost.

      Type: Passive, Familiar

      Item Pool: Item Room

    * item room, treasure room, item room pool, red

  • Lil Haunt

    ItemID: 277

    "Fear him"

    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

    * item room, treasure room, item room pool, white, lil' haunt

  • Dark Bum

    ItemID: 278

    "He wants to take your life"

    A familiar beggar similar to Bum Friend that follows Isaac and collects red hearts, giving Isaac soul hearts or spiders in return.

    For every 1.5 red hearts he takes, he will give 1 heart/spider in return.

    Soul hearts are the most common payout with only a small chance to spawn friendly, hostile spiders or black hearts.

    Counts as 1 of 3 bum items needed towards the Super Bum transformation.

      Type: Passive, Familiar

      Item Pool: Item Room, Devil Room

    * devil pool, devil room pool, devil deal, item room, treasure room, item room pool, celebrate good times come on, the lost item pool, qt 3.14, dark bum, otp, damn it reddit, horns, grey, gray, smile

  • Big Fan

    ItemID: 279

    "Fat protector"

    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

    * item room, treasure room, item room pool, fat, brown

  • Sissy Long Legs

    ItemID: 280

    "She loves you"

    An adorable friendly blue spider that walks around the room laying other blue spiders which attack enemies.

    Blue Spiders do 2.5x 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.

      Type: Passive, Familiar

      Item Pool: Item Room

    * item room, treasure room, item room pool, qt 3.14, dark bum, otp, damn it reddit, blue, derpface

  • Punching Bag

    ItemID: 281

    "Scape goat"

    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

    * item room, treasure room, item room pool, sad, baby, lumpy, brown, pink

  • How To Jump

    ItemID: 282

    "It's time you learned how"

    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

    * library pool, library room, book room pool, item room, treasure room, item room pool, mario, cartridge, nes, grey, gray, orange

  • D100

    Special item

    ItemID: 283

    "REEROLLLLL!"

    When used, rerolls each item you currently own into another item room pool item and any pedestal items and pickups in the room.

    Has the combined uses of the D4, D6 and D20.

    UNLOCK: Unlock this item by beating Boss Rush with The Lost.

      Type: Active

      Recharge Time: 6 rooms

      Item Pool: Item Room

    * item room, treasure room, item room pool, deathstar, death star, dice pip, white, circle, sphere

  • D4

    ItemID: 284

    "Reroll into something else"

    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.

    Each time an item is generated by the D4, it is also removed from the pool. When the pool is empty, it will eventually re-roll all your items into heart containers.

    Cannot remove Azazel's Brimstone laser.

    UNLOCK: Unlock this item by blowing up 30 slot machines.

      Type: Active

      Recharge Time: 6 rooms

      Item Pool: Item Room

    * item room, treasure room, item room pool, dice pip, starting, pyramid, green, triange

  • D10

    ItemID: 285

    "Rerolls enemies"

    When used, rerolls all enemies in the room which are currently alive into another random type of enemy from any floor.

    Dangerous to use in early floors, it could replace a basement enemy with something usually found in the Womb only.

    Cannot reroll mini-bosses or bosses.

      Type: Active

      Recharge Time: 1 room

      Item Pool: Item Room

    * item room, treasure room, item room pool, DIO, dice pip, orange, brown, turban

  • Blank Card

    ItemID: 286

    "Card Mimic"

    When used, copies the effect of the card or rune you are currently holding without consuming it.

    Doesn't work with pills.

    Allows game breaking combinations with the Jera rune by chaining batteries and pickups and using it multiple times.

    An item that often appears in the shop.

    Using this with the ? card will teleport you to the I AM ERROR room.

    UNLOCK: Unlock this item by beating the Isaac boss with Eden.

      Type: Active

      Recharge Time: 4 rooms.

      Item Pool: Item Room, Shop, Secret Room

    * secret room pool, shop room pool, shop item pool, item room, treasure room, item room pool, white, square

  • Book of Secrets

    ItemID: 287

    "??????"

    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.

    UNLOCK: Unlock this item by beating Satan with Eden.

      Type: Active

      Recharge Time: 6 rooms

      Item Pool: Item Room, Library, Secret Room

    * library pool, library room, book room pool, secret room pool, item room, treasure room, item room pool, question mark book, white

  • Box of Spiders

    ItemID: 288

    "It's a box of spiders"

    When used, spawns 1-4 friendly blue spiders on the floor.

    Blue Spiders do 2.5x 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

    * item room, treasure room, item room poolgrey, gray

  • Red Candle

    ItemID: 289

    "Flame on"

    Allows you to fire a red flame infront of you, similar to the Blue Candle item, however the flame will stay for the current room.

    Each flame deals 125 total damagebefore it disappears.

    The flame will shrink in size when deals damage to something and eventually disappear.

    UNLOCK: Unlock this item by donating 400 pennies to the Shop.

      Type: Active

      Recharge Time: Timed (A few seconds)

      Item Pool: Shop

    * shop room pool, shop item pool

  • The Jar

    ItemID: 290

    "Save your life"

    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

    * shop room pool, shop item pool, the lost item pool, glass

  • FLUSH!

    ItemID: 291

    "..."

    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: 6 rooms

      Item Pool: Item Room

    * item room, treasure room, item room pool, silver spoon handle, grey, gray, white, toilet

  • The Satanic Bible

    ItemID: 292

    "Reusable evil"

    When used, gives Isaac +1 Black Heart.

    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: Unlock this item by beating the Isaac boss with Azazel.

      Type: Active

      Recharge Time: 6 rooms

      Item Pool: Item Room, Library, Devil Room

    * library pool, library room, book room pool, devil pool, devil room pool, devil deal, item room, treasure room, item room pool, the lost item pool, pentagram, star, grey, gray, red

  • Head of Krampus

    ItemID: 293

    "Krampus rage"

    When used, fires a 4 way brimstone laser in all cardinal directions, dealing a lot of damage to any enemies.

    If playing with Afterbirth+, it has a 50% chance for the beams to rotate 90 degrees around you when used.

    Maximum potential damage is 462 (20-21 ticks of 22 damage if the laser makes contact the whole duration)

    Laser damage does not scale with your damage stat.

    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 a lot more damage.

    UNLOCK: Unlock this item by beating Krampus (Krampus is unlocked by taking 20 devil deal items).

      Type: Active

      Recharge Time: 6 rooms

      Item Pool: None (Krampus only)

    *, horns, grey, gray, white, red, dead, tongue

  • Butter Bean

    ItemID: 294

    "Reusable knockback"

    When used, farts on nearby enemies and knocks them backwards away from Isaac.

    Allows you to reflect projectiles away from Isaac (Afterbirth only feature)

    Every time you swap Butter Bean for a different active item, it has a 10% chance to transform into the 'Wait What?' item when picked up again.

    UNLOCK: Unlock this item by destroying 100 poops.

      Type: Active

      Recharge Time: Timed (A few seconds)

      Item Pool: Item Room, Beggar

    * normal beggar pool, normal judgement pool, coin beggar pool, coin judgement pool, item room, treasure room, item room pool, white

  • Magic Fingers

    ItemID: 295

    "Pay to play"

    Upon use, consumes a coin and deals damage to everything in the room.

    Damage dealt is equal to your tear damage * 2.

      Type: Active

      Recharge Time: Instant

      Item Pool: Item Room, Shop

    * shop room pool, shop item pool, item room, treasure room, item room pool, tissue, box, yellow, grey

  • Converter

    ItemID: 296

    "Convert your soul"

    When used, converts 2 soul or black hearts into 1 red heart container.

    This item will take from your soul hearts first.

      Type: Active

      Recharge Time: Instant

      Item Pool: Shop

    * shop room pool, shop item pool, the lost item pool, blue, gray, grey, yellow, sprocket

  • Pandora's Box

    ItemID: 297

    "? ?"

    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!

    Pandora's Box considers XL floors to always be the first floor of a chapter.

    UNLOCK: Unlock this item by beating the Dark Room with Lazarus.

      Type: Active

      Recharge Time: One time use

      Item Pool: Shop, Red Chest

    * red chest pool, red chest item pool, shop room pool, shop item pool, blue box

  • Unicorn Stump

    ItemID: 298

    "You feel stumped"

    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

    * item room, treasure room, item room pool, white, lump, grey, gray, blob

  • Taurus

    ItemID: 299

    "Speed down + rage is building"

    -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.

    One of the twelve zodiac items available in the game.

      Type: Passive

      Item Pool: Item Room

    * astrology, astronomy, item room, treasure room, item room pool, blue, glow, circle, horns

  • Aries

    ItemID: 300

    "Ramming speed"

    +0.25 Speed up.

    Gives huge horns which stick out, allowing you to deal 18 contact damage if you hit something with enough speed.

    Will not deal contact damage unless you are moving fast enough (at least 0.8 speed), but does not prevent you from taking damage yourself.

    One of the twelve zodiac items available in the game.

      Type: Passive

      Item Pool: Item Room

    * astrology, astronomy, item room, treasure room, item room pool, black, blue, cyan, glow

  • Cancer

    ItemID: 301

    "HP up + you feel protected"

    +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).

    One of the twelve zodiac items available in the game.

      Type: Passive

      Item Pool: Item Room

    * astrology, astronomy, item room, treasure room, item room pool, cyan, black, the lost item pool, blue, glow, 69

  • Leo

    ItemID: 302

    "Stompy"

    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.

    One of the twelve zodiac items available in the game.

    Counts as 1 of 3 size-increasing items needed towards the Stompy transformation.

      Type: Passive

      Item Pool: Item Room

    * astrology, astronomy, item room, treasure room, item room pool, blue, glow, circle, bomb

  • Virgo

    ItemID: 303

    "You feel refreshed and protected"

    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'.

    One of the twelve zodiac items available in the game.

      Type: Passive

      Item Pool: Item Room

    * astrology, astronomy, item room, treasure room, item room pool, blue glow, m

  • Libra

    ItemID: 304

    "You feel balanced"

    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.

    One of the twelve zodiac items available in the game.

      Type: Passive

      Item Pool: Item Room

    * astrology, astronomy, item room, treasure room, item room pool, ohm, blue, glow

  • Scorpio

    ItemID: 305

    "Poison tears"

    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.

    Pre-Afterbirth this dealt 4 or 6 damage, instead of scaling with your tear damage.

    One of the twelve zodiac items available in the game.

      Type: Passive

      Item Pool: Item Room

    * astrology, astronomy, item room, treasure room, item room pool, m, tail, blue, glow

  • Sagittarius

    ItemID: 306

    "Penetrative shot + speed up"

    +0.2 Speed Up.

    Grants piercing tears.

    Tears do not travel through rocks with this item.

    One of the twelve zodiac items available in the game.

      Type: Passive

      Item Pool: Item Room

    *astrology, astronomy, item room, treasure room, item room pool, nys, notyoursagittarius, blue, glow, arrow, cross

  • Capricorn

    ItemID: 307

    "All stats up"

    +1 Health Up.

    +0.5 Damage Up.

    -1 Tear Delay (Tears Up).

    +0.1 Speed Up.

    +1.5 Range Up.

    +1 Key, +1 Bomb, +1 Coin.

    One of the twelve zodiac items available in the game.

      Type: Passive

      Item Pool: Item Room

    * astrology, astronomy, item room, treasure room, item room pool, cyan, black, blue, glow, n, tail

  • Aquarius

    ItemID: 308

    "A trail of tears"

    Leaves a trail of tears on the floor behind Isaac which damages enemies that walk over it for 2 damage per tick.

    One of the twelve zodiac items available in the game.

      Type: Passive

      Item Pool: Item Room

    * astrology, astronomy, item room, treasure room, item room pool, black, blue, cyan, blue, glow, lightning, bolt, hot garbage

  • Pisces

    ItemID: 309

    "Tears up + knockback shot"

    -1 Tear Delay (Tears Up).

    x1.25 Tear Size Up.

    Tears now have a bigger knockback effect, which pushes enemies backwards.

    One of the twelve zodiac items available in the game.

      Type: Passive

      Item Pool: Item Room

    * astrology, astronomy, item room, treasure room, item room pool, h, blue, glow

  • Eve's Mascara

    ItemID: 310

    "Shot speed down + DMG up"

    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: Unlock this item by beating Boss Rush with Eve.

      Type: Passive

      Item Pool: Item Room

    * item room, treasure room, item room pool, makeup, make up, black, grey, gray, square

  • Judas' Shadow

    ItemID: 311

    "Sweet revenge"

    When you die with this item, you respawn in the previous room as Black Judas with 2 black hearts for health.

    Black Judas has a damage multiplier of 2.00 (double Isaac's damage) and an additional +0.1 Speed.

    Black Judas is considered a separate character by the game, however he can be used to unlock Judas' secrets/achievements.

    UNLOCK: Unlock this item by beating Boss Rush with Judas.

      Type: Passive

      Item Pool: Item Room, Devil Room

    * devil pool, devil room pool, devil deal, item room, treasure room, item room pool

  • Maggy's Bow

    ItemID: 312

    "HP up + you feel healthy"

    +1 Health Up.

    All future red hearts now heal for double. Half hearts heal a whole heart and full hearts heal 2 red hearts.

    UNLOCK: Unlock this item by beating Boss Rush with Maggy.

      Type: Passive

      Item Pool: Item Room

    * item room, treasure room, item room pool, the lost item pool, pink, purple, candy

  • Holy Mantle

    ItemID: 313

    "Holy shield"

    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.

    In Afterbirth The Lost starts with this item after donating 879 coins to the Greed Donation Machine.

      Type: Passive

      Item Pool: Item Room, Angel Room

    * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, starting, blue, white, glow, cross

  • Thunder Thighs

    ItemID: 314

    "HP + speed down + you feel strong"

    +1 Health Up.

    -0.4 Speed Down.

    You can now break obstacles by walking over them.

    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

    * item room, treasure room, item room pool, cheetos, cheese, grey, gray, orange, jar

  • Strange Attractor

    ItemID: 315

    "Magnetic tears"

    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

    * item room, treasure room, item room pool, grey, gray, magnet

  • Cursed Eye

    ItemID: 316

    "Cursed charged shot"

    Tears are now charged up and fired rapidly in a burst of up to 4 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

      Type: Passive, Tear Modifier

      Item Pool: Item Room, Secret Room

    * secret room pool, item room, treasure room, item room pool, white, circle, pearl

  • Mysterious Liquid

    ItemID: 317

    "Toxic splash damage"

    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

    * item room, treasure room, item room pool, mystery liquid, grey, gray, green

  • Gemini

    ItemID: 318

    "Conjoined friend"

    A familar that is attached to Isaac, which will seek out and damage any enemies close by for 3 contact damage.

    One of the twelve zodiac items available in the game.

      Type: Passive, Familiar

      Item Pool: Item Room

    * astrology, astronomy, item room, treasure room, item room pool, blue, glow

  • Cain's Other Eye

    ItemID: 319

    "Near sighted friend"

    A familiar eye that bounces around the room slowly and fires tears in the same direction as Isaac.

    Cain's Other Eye deals scaling damage equal to Isaac's tear damage.

    UNLOCK: Unlock this item by beating Boss Rush with Cain.

      Type: Passive, Familiar

      Item Pool: Item Room

    * item room, treasure room, item room pool, eyeball, white, circle, cataract

  • ???'s Only Friend

    ItemID: 320

    "Controlled friend"

    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: Unlock this item by beating Boss Rush with Blue Baby.

      Type: Passive, Familiar

      Item Pool: Item Room

    * item room, treasure room, item room pool, blue fly, big fly, blue baby's only friend, fat, dead

  • Samson's Chains

    ItemID: 321

    "The ol' ball and chain"

    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: Unlock this item by beating Boss Rush with Samson.

      Type: Passive, Familiar

      Item Pool: Item Room, Secret Room

    * secret room pool, item room, treasure room, item room pool, grey, gray, shackle

  • Mongo Baby

    ItemID: 322

    "Mongo friend"

    A familiar that will follow Isaac and copy the effect of one of your other familiars.

    Deals double the damage as normal 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.

      Type: Passive, Familiar

      Item Pool: Item Room

    * item room, treasure room, item room pool, pink, blue, grey, gray

  • Isaac's Tears

    ItemID: 323

    "Collected tears"

    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.

    UNLOCK: Unlock this item by beating the Isaac boss with Isaac.

      Type: Active

      Recharge Time: 1 bar per tear fired

      Item Pool: Item Room

    * item room, treasure room, item room pool, glass, blue, water

  • Undefined

    ItemID: 324

    "Undefined"

    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).

    In Afterbirth I AM ERROR rooms were removed from the final floors, however before this you were able to loop infinitely assuming you could use Undefined to get there.

    UNLOCK: Unlock this item by beating Boss Rush with Eden.

      Type: Active

      Recharge Time: 6 rooms

      Item Pool: Item Room

    * item room, treasure room, item room pool, pink, purple, red, broken

  • Scissors

    ItemID: 325

    "Lose your head"

    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.

    UNLOCK: Unlock this item by dying 100 times.

      Type: Active

      Recharge Time: 2 rooms

      Item Pool: Item Room

    * item room, treasure room, item room pool, grey, gray

  • Breath of Life

    ItemID: 326

    "Invincibility at a cost"

    While you hold the spacebar down with this item, it will empty the charge bar gradually. 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.

    The invincibility effect is shown via a rapid flashing animation.

      Type: Active

      Recharge Time: Timed (1 bar per second)

      Item Pool: Angel Room

    * angel room pool, god room pool, angel room item, white, blue, ball, circle

  • The Polaroid

    ItemID: 327

    "Fate chosen"

    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.

    When unlocked, is guaranteed to drop after the Mom's Foot boss fight.

    UNLOCK: Unlock this item by beating Isaac in the Cathedral 5 times.

      Type: Passive

      Item Pool: None (Mom's foot boss only)

    *, photo, family, kodak

  • The Negative

    ItemID: 328

    "Fate chosen"

    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.

    When unlocked, is guaranteed to drop after the Mom's Foot boss fight.

    UNLOCK: Unlock this item by beating Satan in Sheol 5 times.

      Type: Passive

      Item Pool: None (Mom's foot boss only)

    * mom's foot, mom fight, mom boss, dark room, photo, family, kodak, inverted

  • The Ludovico Technique

    Special item

    ItemID: 329

    "Controlled tears"

    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

    * item room, treasure room, item room pool, eye, pink, grey, gray, robot

  • Soy Milk

    ItemID: 330

    "DMG down + tears way up"

    Very high Tears Up: (delay /4) - 2

    -80% Damage Down.

    x0.5 Tear Size.

    Was a special item prior to Afterbirth.

      Type: Passive, Tear Modifier

      Item Pool: Item Room

    * item room, treasure room, item room pool, white, glass, square

  • GodHead

    Special item

    ItemID: 331

    "God tears"

    Isaac's tears become homing and have a large aura around them, which will deal damage to anything inside its radius.

    +0.5 Damage Up.

    +1.2 Range Up.

    -0.3 Tears Down.

    -0.3 Shot Speed Down

    +0.8 Tear Height.

    UNLOCK: Unlock this item by beating all bosses and completing all post-it note marks in hard mode with The Lost character.

      Type: Passive, Tear Modifier

      Item Pool: Angel Room

    * angel room pool, god room pool, angel room item, yellow, blue, red, triangle, all seeing eye

  • Lazarus' Rags

    ItemID: 332

    "Eternal life?"

    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: Unlock this item by beating the Isaac boss with Lazarus.

      Type: Passive

      Item Pool: Item Room, Angel Room

    * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, starting, bloody, white, bandages

  • The Mind

    ItemID: 333

    "I know all"

    Gives Isaac a full mapping effect, revealing the entire floor and locations of all secret rooms.

    UNLOCK: Unlock this item by beating Satan with The Lost.

      Type: Passive

      Item Pool: Item Room, Angel Room

    * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, yellow, white, triangle

  • The Body

    ItemID: 334

    "I feel all"

    +3 Health Up.

    The three heart containers are pre-filled with red hearts.

    UNLOCK: Unlock this item by beating the Chest with The Lost.

      Type: Passive

      Item Pool: Item Room, Angel Room

    * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, real platinum god, the lost item pool

  • The Soul

    ItemID: 335

    "I am all"

    +2 Soul Hearts.

    Enemy projectiles will now slowly curve away from Isaac and avoid hitting him.

    UNLOCK: Unlock this item by beating Dark Room with The Lost.

      Type: Passive

      Item Pool: Item Room, Angel Room

    * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, blue, white, triangle

  • Dead Onion

    ItemID: 336

    "Toxic aura tears"

    Isaac's tears become large, brown and will penetrate all objects and enemies (piercing + spectral).

    -0.25 Range Down.

    -0.4 Shot Speed Down.

    -0.5 Tear Height.

    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

    * item room, treasure room, item room pool, brown, pink, purple, plant

  • Broken Watch

    ItemID: 337

    "I think its broken"

    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

    * shop room pool, shop item pool, blue, grey, gray, smashed, clock

  • Boomerang

    ItemID: 338

    "It will never leave you"

    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.

      Type: Active

      Recharge Time: Timed (A few seconds)

      Item Pool: Shop

    * shop room pool, shop item pool, crescent, moon, blue, grey, gray

  • Safety Pin

    ItemID: 339

    "Evil up + range + shot speed"

    +5.25 Range Up.

    +0.16 Shot Speed Up.

    +1 Black Heart.

    +0.5 Tear Height.

    When depleted, Black Hearts deal 40 damage to the entire room, in a Necronomicon style effect.

      Type: Passive

      Item Pool: Boss Room

    * boss room pool, boss room item, grey, gray, punk

  • Caffeine Pill

    ItemID: 340

    "Speed up + size down"

    +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

    * boss room pool, boss room item, pro plus, tablet, medicine, white

  • Torn Photo

    ItemID: 341

    "Tears + shot speed up"

    +0.7 Tears Up.

    +0.16 Shot Speed Up.

      Type: Passive

      Item Pool: Boss Room

    * boss room pool, boss room item, grey, orange, family, picture

  • Blue Cap

    ItemID: 342

    "HP + tears + shot speed down"

    +1 Health Up.

    +0.7 Tears Up.

    -0.16 Shot Speed Down.

    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

    * boss room pool, boss room item, mushroom, fungi, fungus

  • Latch Key

    ItemID: 343

    "Luck up"

    +1 Luck Up.

    +1 Soul Heart.

    Spawns 2 keys on the ground.

      Type: Passive

      Item Pool: Boss Room

    * boss room pool, boss room item, brass, bronze, brown, gold

  • Match Book

    ItemID: 344

    "Evil up"

    +1 Black Heart

    +3 Bombs

    When depleted, Black Hearts deal 40 damage to the entire room, in a Necronomicon style effect.

      Type: Passive

      Item Pool: Boss Room

    * boss room pool, boss room item, white, red

  • Synthoil

    ItemID: 345

    "DMG up + range"

    +1.0 Damage Up.

    +5.25 Range Up.

    +0.5 Tear Height.

    Counts as 1 of 3 syringe items needed towards the Spun transformation.

      Type: Passive

      Item Pool: Boss Room

    * boss room pool, boss room item, syringe, needle, grey, purple, pink

  • A Snack

    ItemID: 346

    "HP up"

    +1 Health Up.

      Type: Passive

      Item Pool: Boss Room

    * boss room pool, boss room item, the lost item pool, dog, biscuit, brown, orange

  • Afterbirth Items (95)

  • Diplopia

    ItemID: 347

    "Double item vision"

    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

    *, white, button, eye

  • Placebo

    ItemID: 348

    "Pill mimic"

    When used, copies the effect of the pill you are currently holding without consuming it.

    Does not copy effects of Cards or Runes.

    Can be used to generate infinite batteries with the 48 hour energy pill.

      Type: Active

      Recharge Time: 4 rooms

      Item Pool: Shop, Greed Mode Shop

    *, grey, gray, white, medicine, tablet

  • Wooden Nickel

    ItemID: 349

    "Flip a coin"

    When used, has a 50% chance to drop one random type of coin (penny, nickel or dime)

    UNLOCK: Unlock this item by donating 33 coins to the Greed Donation Machine.

    UNLOCK: Keeper starts with this item after beating Isaac with Keeper.

      Type: Active

      Recharge Time: 1 room

      Item Pool: Shop, Greed Mode Item Room

    * starting, brown, orange, cent,

  • Toxic Shock

    ItemID: 350

    "Mass poison"

    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

    *, green, glow, biohazard

  • Mega Bean

    ItemID: 351

    "Giga fart!"

    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

    *, pink, kidney

  • Glass Cannon

    ItemID: 352

    "Be gentle..."

    When used, reduces your health to half a heart and fires one large piercing spectral tear that does a lot of damage.

    This will affect all hearts including red, soul and black, reducing all of them down to half of one heart.

    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).

      Type: Active

      Recharge Time: 4 seconds

      Item Pool: Item Room, Greed Mode Item Room

    *, silver

  • Bomber Boy

    ItemID: 353

    "Explosive blast!"

    +5 bombs

    Isaac's bombs will now explode in a large cross-shaped pattern (roughly 5 bombs explosions wide).

    This also affects troll bombs.

      Type: Passive

      Item Pool: Item Room, Greed Mode Item Room, Bomb Beggar

    *, man, face, white

  • Crack Jacks

    ItemID: 354

    "Don't swallow the prize!"

    +1 Health Up

    Spawns a random trinket on the floor.

      Type: Passive

      Item Pool: Boss Room

    *, brown, red, tup, carton, box

  • Mom's Pearls

    ItemID: 355

    "Range + luck up"

    +1.25 Range Up.

    +0.5 Tear Height.

    +1 Luck Up.

    Counts as 1 of 3 mom items needed towards the Mom transformation.

      Type: Passive

      Item Pool: Boss Room

    *, white, necklace, grey, gray

  • Car Battery

    ItemID: 356

    "Double charge!"

    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

    *, black, box, cube

  • Box of Friends

    ItemID: 357

    "Double your friends"

    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.

    Lilith starts with this item.

    UNLOCK: Unlock this item by beating Greed Mode with Lilith.

      Type: Active

      Recharge Time: 4 rooms

      Item Pool: Shop, Greed Mode Item Room

    *, gold, black

  • The Wiz

    ItemID: 358

    "Double wiz shot!"

    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

    * Item Room, Greed Mode Item Room, dunce cap, white, hat, cone

  • 8 Inch Nails

    ItemID: 359

    "Stick it to 'em!"

    +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

    *, silver, grey, gray

  • Incubus

    ItemID: 360

    "Dark friend"

    Gives you a familiar demon incubus that follows you and shoots tears exactly the same as Isaac's 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.

    Incubus' tear damage will scale with any future damage ups and stat upgrades you take.

    Lilith starts with this item.

    UNLOCK: Unlock this item by beating Blue Womb (Hush) with Lilith.

      Type: Passive, Familiar

      Item Pool: Devil Room, Greed Mode Devil Room

    * starting, black, red, eyes, wings, bat

  • Fate's Reward

    ItemID: 361

    "Your fate beside you"

    A familiar blue head that will follow Isaac and fire tears copying his tear damage.

    This familiar is very similar to Incubus, however it only copies damage and is not affected by tears or range upgrades.

    UNLOCK: Unlock this item by beating Blue Womb (Hush) with ??? (Blue baby).

      Type: Passive, Familiar

      Item Pool: Item Room, Gold Chest

    *, dead, blue, face

  • Lil Chest

    ItemID: 362

    "What's in the box?"

    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: Unlock this item by beating Greed Mode with Isaac.

      Type: Passive, Familiar

      Item Pool: Item Room, Greed Mode Item Room, Beggar

    * lil' chest, brown, orange, wooden

  • Sworn Protector

    ItemID: 363

    "Protective friend"

    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.

    UNLOCK: Unlock this item by beating Blue Womb (Hush) with The Lost.

      Type: Passive, Familiar

      Item Pool: Angel Room, Greed Mode Angel Room

    *, angel, wings, pink, white

  • Friend Zone

    ItemID: 364

    "Friendly fly"

    A white orbiting fly which deals 3 contact damage per tick to enemies.

    This familiar orbits Isaac at a middle length distance somewhere between Distant Admiration and Forever Alone

    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

    *, white, wings, grey, gray

  • Lost Fly

    ItemID: 365

    "Lost protector"

    A familiar fly that moves in a straight line and attaches itself to the first obstacle or wall it comes into contact with in each room.

    If any enemies walk into its path, it will deal 7 contact damage per tick.

    If the obstacle it is attached to is destroyed then it will continue rolling in the direction it was previously travelling until it meets another wall or obstacle.

      Type: Passive, Familiar

      Item Pool: Item Room, Greed Mode Item Room, Key Beggar

    *, white, wings, grey, gray

  • Scatter Bombs

    ItemID: 366

    "We put bombs in your bombs!"

    +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

    *, clear, transparent

  • Sticky Bombs

    ItemID: 367

    "Egg sack bombs!"

    +5 Bombs.

    This item causes your bombs to stick to enemies.

    When one of your bombs kills an enemy, a bunch of blue spiders are spawned to fight by your side.

      Type: Passive, Bomb Modifier

      Item Pool: Item Room, Greed Mode Item Room, Bomb Beggar, Bomb Beggar

    *, white, cobweb, web

  • Epiphora

    ItemID: 368

    "Intensifying tears"

    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

    *, blue, drops, three, water

  • Continuum

    ItemID: 369

    "Transcendent tears"

    +2.25 Range Up.

    +1.5 Tear Height.

    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

    *, infinity, pink, purple, oo

  • Mr. Dolly

    ItemID: 370

    "Range + tears up"

    +0.7 Tears Up.

    +5.25 Range Up.

    +0.5 Tear Height.

    Spawns 3 random types of hearts on the floor when picked up

      Type: Passive

      Item Pool: Boss Room

    *, pink, blonde, yellow, red, bow, baby

  • Curse of The Tower

    ItemID: 371

    "You feel cursed..."

    Causes Isaac to spawn 6 troll bombs on the floor every time he gets hit, similar to the Anarchist Cookbook mechanic.

      Type: Passive

      Item Pool: Item Room, Red Chest, Curse Room, Greed Mode Item Room

    *, blue, orange, poster, torn, paper, page, ripped

  • Charged Baby

    ItemID: 372

    "Bbbzzzzzt!"

    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

    *, yellow, grey, gray, power

  • Dead Eye

    ItemID: 373

    "Accuracy brings power!"

    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

    *, bullseye, target, grey, gray, black, red, circle

  • Holy Light!

    ItemID: 374

    "Holy shot!"

    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.

      Type: Passive

      Item Pool: Item Room, Greed Mode Item Room, Angel Room

    *, glow, blue, white, black, ball

  • Host Hat

    ItemID: 375

    "Nice hat!"

    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. Stomp damage (i.e. Mom's Foot boss) counts as an explosion and is therefore prevented by Host Hat.

      Type: Passive

      Item Pool: Item Room, Greed Mode Item Room

    *, skull, bone, grey, gray, zoidberg

  • Restock

    ItemID: 376

    "Never ending stores!"

    Causes your shops to instantly restock their items when you buy them.

      Type: Passive

      Item Pool: Shop, Beggar

    *, recycle, green, arrows

  • Bursting Sack

    ItemID: 377

    "Spider love"

    Most spider enemies no longer target or deal contact damage to Isaac.

    This is very similar to a Skatole for spiders instead of flies.

      Type: Passive

      Item Pool: Item Room, Greed Mode Item Room

    *, egg, burst, pop, white, black

  • No. 2

    ItemID: 378

    "Uh oh..."

    Continuously firing or charging tears for 3 seconds causes Isaac to 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.

      Type: Passive

      Item Pool: Item Room, Greed Mode Item Room

    *, yfront, y-front, underpants, underwear, white, grey, gray

  • Pupula Duplex

    ItemID: 379

    "Wide shot"

    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

    *, flat, white, grey, gray, blue, drip, water, eyes

  • Pay To Play

    ItemID: 380

    "Money talks"

    +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 and other key doors.

      Type: Passive

      Item Pool: Shop, Greed Mode Item Room, Greed Mode Shop

    *, grey, gray, metal, slot, rectangle, silver

  • Eden's Blessing

    ItemID: 381

    "Your future shines brighter"

    +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: Unlock this item by beating Blue Womb (Hush) with Eden.

      Type: Passive

      Item Pool: Item Room

    *, white, rose, flower, petal

  • Friendly Ball

    ItemID: 382

    "Gotta fetch 'em all!"

    When used, can be thrown at enemies to capture them (similar to a Poké 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.

      Type: Active

      Recharge Time: 3 rooms.

      Item Pool: Item Room, Greed Mode Item Room

    *, pokemon, grey, gray, blue, deathstar, circle

  • Tear Detonator

    ItemID: 383

    "Remote tear detonation"

    When used, will detonate any tears currently on the screen and cause each one to split into 6 more tears which will fire in a circle, similar to Tammy's Head.

    Luck-based items such as Holy Light are applied to each tear individually.

      Type: Active

      Recharge Time: 1 room.

      Item Pool: Shop, Greed Mode Item Room

    *, blue, tnt, boom

  • Lil Gurdy

    ItemID: 384

    "A gurd of your own!"

    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.

    Lil Gurdy can glide over the top of objects and obstacles in the room.

    At full charge Lil Gurdy deals 6 damage per tick while in contact with an enemy.

      Type: Passive, Familiar

      Item Pool: Item Room, Greed Mode Item Room

    *, pink, brown, circle, eye

  • Bumbo

    ItemID: 385

    "Bumbo want coin!"

    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

    *, pink, face, round, smile, :D

  • D12

    ItemID: 386

    "Rerolls rocks"

    When used, the D12 re-rolls any rocks into another random type of object (e.g. poop, pots, TNT, red poop, stone blocks etc.)

    UNLOCK: Unlock this item by beating Blue Womb (Hush) with Cain.

      Type: Active

      Recharge Time: 3 rooms

      Item Pool: Item Room, Greed Mode Shop

    * die, dice, pip, blue, 12, circle

  • Censer

    ItemID: 387

    "Peace be with you"

    Gives Isaac a familiar golden Censer which creates a huge aura of light that slows down any enemies inside it.

    UNLOCK: Unlock this item by beating Greed Mode with Maggy.

      Type: Passive, Familiar

      Item Pool: Angel Room, Greed Mode Angel Room

    *, gold, vase, cross

  • Key Bum

    ItemID: 388

    "He wants your keys!"

    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: Unlock this item by beating Greed Mode with Lazarus.

      Type: Passive, Familiar

      Item Pool: Item Room, Secret Room, Key Beggar

    *, grey, gray, black, face, stone, rock, baby

  • Rune Bag

    ItemID: 389

    "Rune generator"

    A bag that follows Isaac and drops a random mystic rune every 5 or 6 rooms.

    UNLOCK: Unlock this item by beating the Isaac boss with Lilith.

      Type: Passive, Familiar

      Item Pool: Item Room, Secret Room, Greed Mode Item Room

    *, purple, sack, pouch, pink

  • Seraphim

    ItemID: 390

    "Sworn friend"

    A familiar angel which follows Isaac and fires Sacred Heart tears which deal 10 damage at -25% shot speed and a reduced fire rate.

      Type: Passive, Familiar

      Item Pool: Item Room, Angel Room, Greed Mode Angel Room

    *, angel, halo, wings, blue, white, baby

  • Betrayal

    ItemID: 391

    "Turn your enemy"

    Every time Isaac takes damage, a charm effect is applied to every enemy in the room, causing them to attack each other rather than Isaac.

    The effect will not trigger if there are less than 2 enemies in the room.

    UNLOCK: 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

    *, red, silver, dagger, knife, bloody

  • Zodiac

    ItemID: 392

    "The heavens will change you"

    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.

    UNLOCK: Unlock this item by beating Greed Mode with The Lost.

      Type: Passive

      Item Pool: Item Room, Greed Mode Item Room

    *, cross, white, circle

  • Serpent's Kiss

    ItemID: 393

    "The kiss of death"

    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 have a 20% chance to drop a black sin heart when killed.

    UNLOCK: Unlock this item by beating Satan with Lilith.

      Type: Passive

      Item Pool: Item Room, Greed Mode Item Room

    *, green, lips, kiss, drip, drop

  • Marked

    ItemID: 394

    "Directed tears"

    Isaac will now fire tears automatically directed at a red target on the ground which is controlled by the player.

    This allows for a full 360 degree tear firing radius.

    Can be overridden by other tear modifiers such as Mom's Knife or Brimstone.

    +0.7 Tears Up.

    +0.3 Tear Height.

    +3.15 Range Up.

    Has no effect with Lilith's Incubus

      Type: Passive

      Item Pool: Item Room, Greed Mode Item Room

    *, red, cross, circle

  • Tech X

    ItemID: 395

    "Laser ring tears"

    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 equal to your normal tears rapidly to any enemies inside the ring.

    Rings have infinite range and travel until they hit a wall.

      Type: Passive, Tear modifier

      Item Pool: Item Room, Greed Mode Item Room

    * tech 10, tech ten, donut laser rings, vr, headset, visor

  • Ventricle Razor

    ItemID: 396

    "Short cutter"

    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

    *, scalpel, red, silver, white, grey, gray, metal, knife, cut

  • Tractor Beam

    ItemID: 397

    "Controlled tears"

    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.

    +5.25 Range Up.

    +0.16 Shot Speed Up.

    +0.5 Tear Height.

    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

    *, blue, glow, silver, grey, gray, light

  • God's Flesh

    ItemID: 398

    "Shrink shot!"

    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

    *, mushroom, pink,

  • Maw of The Void

    ItemID: 399

    "Consume thy enemy!"

    +1.0 Damage Up.

    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.

    Enemies killed with the black ring have a 5% chance to drop Black hearts.

    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: Unlock this item by beating Blue Womb (Hush) with Azazel.

      Type: Passive

      Item Pool: Devil Room, Greed Mode Devil Room

    *, red, circle, blood, paint

  • Spear of Destiny

    ItemID: 400

    "Your destiny"

    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

    *, grey, silver, sword, dagger, blade, knife

  • Explosivo

    ItemID: 401

    "Sticky bomb shot!"

    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.

      Type: Passive

      Item Pool: Item Room, Greed Mode Item Room

    *, orange, black, ball, circle, explode

  • Chaos

    ItemID: 402

    "!!!"

    When picked up, drops between 1-6 random pickups on the floor.

    Causes all item pedestals to be chosen from a random item pool instead of the pre-defined ones which normally exist.

    If an item is chosen from an exhausted pool, it will spawn a Breakfast item instead.

    Fixed item drops won't be replaced - e.g. Cube of Meat after defeating a Horseman.

      Type: Passive

      Item Pool: Shop, Greed Mode Shop

    *, red, cross

  • Spider Mod

    ItemID: 403

    "Mod buddy!"

    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

    *, robot, red, grey, gray, silver, metal, antenna

  • Farting Baby

    ItemID: 404

    "He farts!"

    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.

    UNLOCK: Unlock this item by beating Blue Womb (Hush) with Isaac.

      Type: Passive, Familiar

      Item Pool: Item Room

    * fart baby, green, fat

  • GB Bug

    ItemID: 405

    "Game breaking bug, right away!"

    A glitch familiar that bounces around the room. It deals 8 damage per tick to enemies and applies a random status effect to any enemies it comes into contact with (e.g. slow, burning)

    If the GB Bug passes over a consumable, it has a chance to reroll it into another random consumable.

    UNLOCK: Unlock this item by beating Greed Mode with Eden.

      Type: Passive

      Item Pool: Item Room, Secret Room, Greed Mode Shop

    *, red, yellow, green, white, square, rectangle

  • D8

    ItemID: 406

    "Reroll stats"

    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: Unlock this item by beating Challenge #28 (Pride Day).

      Type: Active

      Recharge Time: 4 Rooms

      Item Pool: Item Room, Greed Mode Shop

    * dice, pip, die, black, grey, gray, pyramid, triangle

  • Purity

    ItemID: 407

    "Aura stat boost"

    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 = +7.5 Range Up, +1.0 Tear Height

    UNLOCK: Unlock this item by beating Blue Womb (Hush) with Maggy.

      Type: Passive

      Item Pool: Item Room, Greed Mode Item Room, Greed Mode Angel Room

    *, white, flower, lotus, petal, rose

  • Athame

    ItemID: 408

    "Call to the void"

    Now when you take damage, a black ring will appear around Isaac that damages any enemies in contact with it.

    The ring damage scales with your tear damage.

    Enemies killed with the black ring have a 15% chance to drop black hearts.

    UNLOCK: Unlock this item by beating Blue Womb (Hush) with Eve.

      Type: Passive

      Item Pool: Devil Room, Curse Room, Greed Mode Devil Room

    *, grey, gray, silver, metal grabber, hand, robot

  • Empty Vessel

    ItemID: 409

    "I reward an empty vessel"

    +2 Black Hearts

    When Isaac has no red hearts, this item gives Isaac the ability to fly. Every 40 seconds since 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: Unlock this item by beating Blue Womb (Hush) with Lazarus.

      Type: Passive

      Item Pool: Devil Room, Greed Mode Devil Room

    *, red, grey, gray, black, bomb

  • Evil Eye

    ItemID: 410

    "Eye shot!"

    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: Unlock this item by beating Greed Mode with Cain.

      Type: Passive

      Item Pool: Item Room, Greed Mode Item Room

    *, blue, glow, circle

  • Lusty Blood

    ItemID: 411

    "Their blood brings rage!"

    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: Unlock this item by beating Greed Mode with Samson.

      Type: Passive

      Item Pool: Item Room, Greed Mode Item Room

    *, red, heart, bleed, bloody

  • Cambion Conception

    ItemID: 412

    "Feed them hate"

    After taking enough damage you will gain a permanent demon familiar.

    Possible familiars include: Dark Bum, Demon Baby, Leech, Lil' Brimstone, Succubus, Incubus.

    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: Unlock this item by beating ??? with Lilith.

      Type: Passive

      Item Pool: Devil Room, Greed Mode Devil Room

    *, red, organ, lung, starting

  • Immaculate Conception

    ItemID: 413

    "Feed them love"

    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: Unlock this item by beating Boss Rush with Lilith.

      Type: Passive

      Item Pool: Angel Room, Greed Mode Angel Room

    *, white, halo

  • More Options

    ItemID: 414

    "There are even more options!"

    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

    *, orange, question, mark, gold, ?

  • Crown of Light

    ItemID: 415

    "The untainted gain power"

    +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, +5.25 Range Up, +0.5 Tear Height and -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

    *, blue, glow

  • Deep Pockets

    ItemID: 416

    "More stuff to carry!"

    Allows you to carry two cards/pills/runes at the same time.

    UNLOCK: Unlock this item by beating The Chest floor with Keeper.

      Type: Passive

      Item Pool: Shop, Greed Mode Item Room, Greed Mode Shop

    *, grey, gray, bag, stone, rock

  • Succubus

    ItemID: 417

    "Damage booster"

    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 30% of your tear damage to enemies per tick

    UNLOCK: Unlock this item by beating The Lamb with Lilith.

      Type: Passive, Familiar

      Item Pool: Devil Room, Demon Beggar

    *, black, red, wings, grey, gray

  • Fruit Cake

    ItemID: 418

    "Rainbow effects!"

    Gives you a different tear effect with every tear that you fire.

    Tear effects include: Anti-Gravity, GodHead, Proptosis, Tiny Planet, Holy Light, Soy Milk, Cricket's Body, Explosivo, Continuum, My Reflection, Ring Worm, Hook Worm, Wiggle Worm, Flat 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

    *, brown, red, green, orange, pile, dirt

  • Teleport 2.0

    ItemID: 419

    "I-teleport!"

    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

    *, golden, yellow, robot, antenna, black

  • Black Powder

    ItemID: 420

    "Spin the black circle!"

    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.

      Type: Passive

      Item Pool: Devil Room, Greed Mode Devil Room

    *, black, grey, gray, bag, sack, pouch

  • Kidney Bean

    ItemID: 421

    "Love toots!"

    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.

      Type: Active

      Recharge time: 2 Rooms

      Item Pool: Item Room, Greed Mode Item Room

    *, red

  • Glowing Hour Glass

    ItemID: 422

    "Turn back time"

    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.

    Specific consumables such as The Joker card can't be restored.

      Type: Active

      Recharge time: 2 rooms

      Item Pool: Item Room, Shop

    * hourglass, hour glass, egg, timer, blue, brown

  • Circle of Protection

    ItemID: 423

    "Protect me from myself"

    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

    *, white, bandana, circle, bandage

  • Sack Head

    ItemID: 424

    "More sacks!"

    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.

      Type: Passive

      Item Pool: Shop

    *, bag, grey, cry, blue, tear, shia

  • Night Light

    ItemID: 425

    "Scared of the dark?"

    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

    * Shop, Greed Mode Item Room, white, blue, inhaler

  • Obsessed Fan

    ItemID: 426

    "Follows my every move...""

    A purple familiar fly that follows your exact movement on a 3 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, Greed Mode Item Room

    *, purple, fly

  • Mine Crafter

    ItemID: 427

    "Booom!"

    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

    *, orange, brown

  • PJs

    ItemID: 428

    "You feel cozy"

    +4 Soul Hearts

    Fully restores your red health.

      Type: Passive

      Item Pool: Boss Room

    *, blue, baby, grow, headless

  • Head of the Keeper

    ItemID: 429

    "Penny tears!"

    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 and also appear in the Gold Chest pool.

      Type: Passive

      Item Pool: Gold Chest, Greed Mode Gold Chest, Dead shopkeeper

    *, gold, eyes, grey, gray

  • Papa Fly

    ItemID: 430

    "Turret follower"

    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, Greed Mode Item Room

    *, blue

  • Multidimensional Baby

    ItemID: 431

    "ydduB Buddy"

    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, +4.0 tear height.

      Type: Passive, Familiar

      Item Pool: Item Room, Greed Mode Item Room, Devil Room, Greed Mode Devil Room

    *, grey, gray, black, ghost

  • Glitter Bombs

    ItemID: 432

    "Prize bombs!"

    +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.

      Type: Passive, Bomb Modifier

      Item Pool: Item Room, Greed Mode Item Room

    *, pink, sparkle

  • My Shadow

    ItemID: 433

    "Me! And my shaaaadow!"

    Each time you take damage, My Shadow will apply a fear effect to all enemies in the room and spawn a familiar black charger that will attack for you.

    The charger deals 5 damage, and will be killed if it is hurt too much.

    UNLOCK: Unlock this item by beating Greed Mode with Judas.

      Type: Passive

      Item Pool: Devil Room, Greed Mode Devil Room

    *, black, outline, upside, down

  • Jar of Flies

    ItemID: 434

    "Gotta catch 'em all?"

    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

    *, glass, bottle

  • Lil Loki

    ItemID: 435

    "4-way buddy!"

    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

    *, red, devil, baby, face

  • Milk!

    ItemID: 436

    "Dont cry over it..."

    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

    *, glass, white, cup

  • D7

    ItemID: 437

    "Reroll rewards!"

    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.

    Will teleport you to out of the room if used in a Boss Room or Devil Room.

    If used in a greed fight it can be used to reroll the room into a Shop.

      Type: Active

      Recharge time: 3 rooms

      Item Pool: Item Room

    * dice, pip, die, turban, white, grey, gray

  • Binky

    ItemID: 438

    "Memories..."

    +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

    * pacifier, dummy, baby, blue, white

  • Mom's Box

    ItemID: 439

    "What's inside?"

    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

    *, black, purple

  • Kidney Stone

    ItemID: 440

    "Matt's kidney stone"

    Randomly while firing tears, Isaac will stop firing and turn red, where he will charge and release a lot of 'tears' in one go. In the burst of tears is a kidney stone which deals a lot of damage.

    -0.2 Speed Down.

    -17 Range Down.

    +2.0 Tear height

    The large decrease in range and tear height increase cause this item to overall be a slight range down.

    UNLOCK: Unlock this item by beating Challenge #29 (Onan's Streak).

      Type: Passive

      Item Pool: Item Room, Greed Mode Item Room

    *, bloody, brown, hair, wig, scalp

  • Mega Blast

    ItemID: 441

    "Laser breath"

    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: Unlock this item by beating Mega Satan with every character.

      Type: Active

      Recharge time: 12 rooms.

      Item Pool: Devil Room, Greed Mode Devil Room

    *, red, grey, gray, brown, black, red, eyes

  • Afterbirth Plus Items (110)

  • Dark Princes Crown

    ItemID: 442

    "Loss is power"

    A crown appears above your head and while at exactly 1 full red heart of health, you gain a +1.5 Range Up, +0.75 Tears Up, +0.20 Shot Speed Up and +1 Tear Height.

    Any time your health changes to be not exactly 1 red heart you lose the effect

    This item does nothing with The Lost

    Similar to other standard 'Tears Up' (not Tear Delay) items, if you are already at the soft tear rate cap this item does not give you a tears up.

    UNLOCK: Unlock this item by defeating Delirium as Azazel.

      Type: Passive

      Item Pool: Devil Room, Curse Room

    *, red, glow

  • Apple!

    ItemID: 443

    "Trick or treat?"

    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

    *, red

  • Lead Pencil

    ItemID: 444

    "Hes a bleeder!"

    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.

    Each of the tears in the cluster deals double damage

      Type: Passive

      Item Pool: Item Room

    *, yellow, pen

  • Dog Tooth

    ItemID: 445

    "Bark at the moon!"

    +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

    *, white, silver

  • Dead Tooth

    ItemID: 446

    "Halitosis"

    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

    *, grey, gray, brown, face, rabbit

  • Linger Bean

    ItemID: 447

    "Crying makes me toot"

    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

    *, pink

  • Shard of Glass

    ItemID: 448

    "Blood and guts!"

    Upon taking damage, this item gives a 25% chance to drop a full red heart.

    Also an additional 10% chance to gain the Anemic effect for the room (+5 range, and leave a trail of damaging red creep).

      Type: Passive

      Item Pool: Item Room

    *, blue, triangle, pyramid

  • Metal Plate

    ItemID: 449

    "It itches..."

    +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

    *, silver, metal, grey, gray

  • Eye of Greed

    ItemID: 450

    "Gold tears!"

    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: Unlock this item by defeating Greedier Mode with Keeper.

      Type: Passive

      Item Pool: Secret Room

    *, cent, coin, silver, metal, grey, gray

  • Tarot Cloth

    ItemID: 451

    "I see the future"

    Drops a random card or rune on pickup

    Doubles the effect of certain tarot cards

    For some cards this does not double the effect (e.g. Stars card only teleports you once). In general if a card has a number of things, that thing is doubled. e.g. Jera quadruples pickups, and Black Rune deals 80 damage instead of 40.

      Type: Passive

      Item Pool: Shop, Curse Room

    *, purple, grey, bag

  • Varicose Veins

    ItemID: 452

    "I'm leaking..."

    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

    *, red, tube

  • Compound Fracture

    ItemID: 453

    "Bone tears!"

    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.

    +1.5 Range Up.

    +1.0 Tear Height.

    UNLOCK: Unlock this item by defeating Delirium in The Void floor with Lazarus.

      Type: Passive

      Item Pool: Item Room

    *, bone, broken, snapped, white, bloody

  • Polydactyly

    ItemID: 454

    "Hold me!"

    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: Boss Room

    *, pink

  • Dad's Lost Coin

    ItemID: 455

    "I remember this..."

    +1.5 Range Up

    Drops a lucky penny

    UNLOCK: Unlock this item by beating Greedier Mode with The Lost.

      Type: Passive

      Item Pool: Boss Room, Beggar

    *, silver, metal, grey, gray, omega

  • Moldy Bread

    ItemID: 456

    "Midnight snack!"

    +1 Health Up

      Type: Passive

      Item Pool: Boss Room, Beggar

    *, sandwich, toast, brown, green, bite, bitten

  • Cone Head

    ItemID: 457

    "Hard headed!"

    +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

    * northernlion, nl, northern lion, ryan letourneau, egg, egg father, egg daddy, dad, BALD, northernlion's head resembles an egg much like this item, isn't that hilarious?, pink

  • Belly Button

    ItemID: 458

    "Whats in there?"

    Drops one random trinket on pickup.

    Gives you an extra trinket slot.

      Type: Passive

      Item Pool: Boss Room

    *, pink, circle, cross

  • Sinus Infection

    ItemID: 459

    "Booger tears!"

    Isaac's tears have a random 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 until the enemy is dead or 60 seconds has passed.

      Type: Passive

      Item Pool: Item Room

    * bogey, boger, green, drop, drip, boogey,

  • Glaucoma

    ItemID: 460

    "Blind tears!"

    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

    *, white, circle, eye, circle

  • Parasitoid

    ItemID: 461

    "Egg tears!"

    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.

      Type: Passive

      Item Pool: Item Room

    *, blue, fly

  • Eye of Belial

    ItemID: 462

    "Possessed tears!"

    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.

    +1.5 Range Up.

    +1.0 Tear Height.

    UNLOCK: Unlock this item by defeating Greedier Mode with Judas.

      Type: Passive

      Item Pool: Devil Room

    *, red, circle

  • Sulfuric Acid

    ItemID: 463

    "Acid tears!"

    +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

    *, orange, yellow, bottle, X

  • Glyph of Balance

    ItemID: 464

    "A gift from above"

    +2 Soul Hearts

    This item will modify drops from 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: Unlock this item by defeating Greedier mode with Maggy.

      Type: Passive

      Item Pool: Angel Room

    *, blue, triangle

  • Analog Stick

    ItemID: 465

    "360 tears!"

    +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

    *, grey, gray, mushroom

  • Contagion

    ItemID: 466

    "Outbreak!"

    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

    *, red, glow, biological, danger

  • Finger!

    ItemID: 467

    "Watch where you point that!"

    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

    *, thumb, toe, pink, bone

  • Shade

    ItemID: 468

    "It follows"

    Isaac gains a shadow familiar that will follow Isaac's movement pattern delayed by 1 second and deal 2 contact damage to enemies per tick.

    Shade is absorbed by Isaac after dealing 600 damage. This spawns friendly charger enemies and causes Isaac to deal 2 contact damage (same as the shade did). This effect stacks with multiple shades, scaling the contact damage each time.

    UNLOCK: Unlock this item by defeating Delirium in The Void floor with Judas.

      Type: Passive, Familiar

      Item Pool: Devil Room, Curse Room

    *, blue, white, eyes

  • Depression

    ItemID: 469

    ":("

    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

    *, pink, purple, cloud, smoke

  • Hushy

    ItemID: 470

    "Lil hush!"

    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: Unlock this item by beating Hush with Apollyon.

      Type: Passive, Familiar

      Item Pool: Item Room

    *, blue, pacman, ghost, face

  • Lil Monstro

    ItemID: 471

    "Ain't he cute?"

    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 Mosntro's tears each deal base damage (3.5) and does not scale with damage upgrades

      Type: Passive, Familiar

      Item Pool: Item Room

    *, head, cleft, lip, palate, hairlip, tooth

  • King Baby

    ItemID: 472

    "Lord of the dead!"

    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.

    UNLOCK: Unlock this item by beating Delirium on The Void floor with ???.

      Type: Passive, Familiar

      Item Pool: Shop

    *, blue, crown, gold, yellow

  • Big Chubby

    ItemID: 473

    "Chub chub"

    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.

      Type: Passive, Familiar

      Item Pool: Item Room

    *, face, yellow, brown

  • Tonsil

    ItemID: 474

    "Gross..."

    Gives you a Tonsil familiar, which follows Isaac and blocks enemy projectiles.

    Does not deal contact damage to enemies.

    The Tonsil familiar counts as a passive item but does not appear in any item pools, meaning the only ways to find it and make it appear in your Items Collection page are a) hold the Tonsil trinket and trigger the effect, or b) start with it randomly as Eden.

      Type: Passive, Familiar

      Item Pool: None

    *, pink, bloody, brain

  • Plan C

    ItemID: 475

    "Use with caution"

    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: 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

    *, red, pill, medicine, drug

  • D1

    ItemID: 476

    "What will it be?"

    When used, the D1 duplicates 1 random pickup in the current room, including cards, runes, chests and trinkets.

    If you drop your current card, rune or pill and duplicate it, this item can effectively act similar to the Blank Card and Placebo items.

    Jera runes 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: Unlock this item by defeating Greedier Mode with Isaac.

      Type: Active

      Recharge time: 4 rooms

      Item Pool: Item Room

    *, white, grey, gray, dice pip, one

  • Void

    ItemID: 477

    "Consume"

    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: Unlock this item by beating Delirium in The Void floor with Apollyon.

      Type: Active

      Recharge time: 6 rooms

      Item Pool: Devil Room, Angel Room

    *, purple, swirl, spin, black

  • Pause

    ItemID: 478

    "Stop!"

    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

    *, green, robot, antenna

  • Smelter

    ItemID: 479

    "Trinket melter!"

    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: Unlock this item by beating Mom's Heart on Hard Mode with Apollyon.

      Type: Active

      Recharge time: 6 rooms

      Item Pool: Shop

    *, grey, gray, brown, orange, steam, coffee, tea, drink, cup

  • Compost

    ItemID: 480

    "Gain more friends!"

    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, Secret Room

    *, green, brown, grey, gray, ball

  • Dataminer

    ItemID: 481

    "109"

    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

    * data miner, red, pickaxe, minecraft, pixel

  • Clicker

    ItemID: 482

    "Change"

    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 Black 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

    *, grey, gray, black, remote, zapper, changer, building

  • MaMa Mega!

    ItemID: 483

    "BOOOOOOOOOM!"

    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

      Type: Active

      Recharge time: One time use

      Item Pool: Shop, Bomb Beggar

    *, bomb, face, red, lips

  • Wait What?

    ItemID: 484

    "I can't believe it's not butter bean!"

    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

    *, white, yellow, bean

  • Crooked Penny

    ItemID: 485

    "50/50"

    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: Unlock this item by defeating Delirium in The Void floor with Keeper.

      Type: Active

      Recharge time: 4 rooms

      Item Pool: Item Room, Shop, Beggar

    *, orange, brown, yellow, gold, coin, cent

  • Dull Razor

    ItemID: 486

    "I feel numb..."

    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: Unlock this item by defeating Delirium on The Void floor with Eve.

      Type: Active

      Recharge time: 2 rooms

      Item Pool: Shop

    *, blue, pink, purple

  • Potato Peeler

    ItemID: 487

    "A pound of flesh..."

    When used, this item permanently removes one of your red heart containers and gives you a flat +0.2 Damage Up, the Anemic effect (+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

    *, brown, metal, silver, grey, gray

  • Metronome

    ItemID: 488

    "Waggles a finger"

    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: Unlock this item by defeating Greedier Mode with Eden.

      Type: Active

      Recharge time: 2 rooms

      Item Pool: Item Room

    *, grey, gray, brown

  • D infinity

    ItemID: 489

    "Reroll forever"

    When picked up, this item gives you a random Dice active item, which will transform into another random dice upon use

    Possible dice include: D4, D6, D8, D10, D12, D20, D100

    All dice given by this item have a 2 room recharge time

    UNLOCK: Unlock this item by defeating Delirium in The Void floor with Isaac.

      Type: Active

      Recharge time: 2 rooms

      Item Pool: Item Room

    *, grey, gray, cube, box, oo, square

  • Eden's Soul

    ItemID: 490

    "..."

    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: 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

    *, blue, circle, spikes

  • Acid Baby

    ItemID: 491

    "Pills pills pills!"

    Every 3 rooms Acid Baby will drop a random pill

    The first pill drops after 2 rooms

    Every time you use a pill, Acid Baby will poison all enemies in the room, dealing double your tear damage to each of them

      Type: Passive, Familiar

      Item Pool: Item Room, Demon Beggar

    *, brown, yellow, face, red, eyes, ghost

  • YO LISTEN!

    ItemID: 492

    "Yo listen!"

    +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

      Type: Passive, Familiar

      Item Pool: Item Room

    * navi, blue, green, fly

  • Adrenaline

    ItemID: 493

    "Panic - power"

    For every empty red heart container, Isaac gains +0.2 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.

      Type: Passive

      Item Pool: Item Room

    * Adderline, pink, syringe, needle, injection

  • Jacob's Ladder

    ItemID: 494

    "Electric tears"

    Isaac gains electric tears, which fire 1-2 sparks of electricty in random directions upon hitting any object or enemy

    The electricty deals half of your normal tear damage

    Tear effects will still apply to your electricty sparks in a lot of cases (e.g. Spoon Bender will give them a homing effect)

    Tears which fall naturally to the floor at max range do not generate sparks

      Type: Passive

      Item Pool: Item Room

    *, silver, metal, grey, gray, blue

  • Ghost Pepper

    ItemID: 495

    "Flame tears"

    Each tear now has a small chance to be a fire instead, which deals 23 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

      Type: Passive

      Item Pool: Item Room

    *, white, face

  • Euthanasia

    ItemID: 496

    "Needle shot"

    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 every time

    Counts as 1 of 3 syringe items needed towards the Spun transformation.

    UNLOCK: Unlock this item by defeating Delirium in The Void floor with Lilith.

      Type: Passive

      Item Pool: Item Room, Curse Room, Demon Beggar

    *, black, syringe, injection

  • Camo Undies

    ItemID: 497

    "Camo kid"

    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

      Type: Passive

      Item Pool: Item Room

    *, pink, purple, goggles

  • Duality

    ItemID: 498

    "You feel very balanced"

    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: Unlock this item by defeating Greedier Mode with Lilith.

      Type: Passive

      Item Pool: Devil Room, Angel Room

    *, black, white, circle

  • Eucharist

    ItemID: 499

    "Peace be with you"

    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: Unlock this item by defeating Delirium in The Void floor with Maggy.

      Type: Passive

      Item Pool: Angel Room

    *, golden, yellow, white, cross

  • Sack of Sacks

    ItemID: 500

    "Gives Sacks!"

    A sack familiar that drops a sack every 5 or 6 rooms cleared (alternates between 5 and 6)

    UNLOCK: Unlock this item by defeating Greedier Mode as Cain.

      Type: Passive, Familiar

      Item Pool: Shop, Golden Chest

    * back in black, ac/dc, bag, brown, pouch, pocket, bulge

  • Greed's Gullet

    ItemID: 501

    "Money = Health!"

    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: Unlock this item by beating Challenge #35 (Pong).

      Type: Passive

      Item Pool: Secret Room

    *, dollar, cash, sack, bag, pouch

  • Large Zit

    ItemID: 502

    "Creep shots"

    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

    *, pink, yellow, toe, nail, tooth

  • Little Horn

    ItemID: 503

    "Science!"

    While firing tears you have a 5% chance to fire a piercing void tear, that will instantly kill any non-boss enemy it comes into contact with

    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)

      Type: Passive

      Item Pool: Curse Room, Demon Beggar

    *, black, tooth

  • Brown Nugget

    ItemID: 504

    "Friendly Fly"

    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 2 damage each and do not scale with your own damage stat

    UNLOCK: Unlock this item by defeating Ultra Greed as Apollyon.

      Type: Active

      Recharge time: 7 seconds

      Item Pool: Item Room

    *, brown, cube, rock, brownie, dirt

  • Poke Go

    ItemID: 505

    "Gotta catch em..."

    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

    * pokemon, phone, black, green, blue, gps

  • BackStabber

    ItemID: 506

    "Watch your back!"

    Every time one of your tears hits an enemy, it has a chance to start bleeding, which will cause it to take damage equal to 10% of its maximum health every 5 seconds.

    Damaging enemies from behind gives the bleed effect a 100% chance to apply

    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

    *, knife, dagger, red, heart, silver, knife

  • Sharp Straw

    ItemID: 507

    "More blood!"

    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 or 1/2 soul hearts.

    Half red hearts will always drop when the player has at least one red heart container, otherwise half soul hearts will drop.

      Type: Active

      Recharge time: 8 seconds

      Item Pool: Item Room

    *, blue, white, stripe

  • Mom's Razor

    ItemID: 508

    "It's sharp!"

    A razor blade orbital that deals contact damage and applies the bleeding status effect to enemies, which will cause them to take damage equal to 10% of their total health every 5 seconds

    The contact damage dealt by Mom's Razor is equal to 20% of your current tear damage (scales with damage upgrades)

    Does not block enemy shots

    The bleed effect does not affect bosses

    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, Curse Room

    *, pink, t

  • Bloodshot Eye

    ItemID: 509

    "Bloody friend"

    An eye orbital that shoots a tear every 2 seconds that deals 3.5 damage and deals 2 contact damage per tick to enemies

    Tears will fire in the direction it is currently facing and do not target enemies

    Unlike other orbitals, this item does not block enemy projectiles

    The damage dealt by this orbital does not scale with damage upgrades

    Its speed is not affected by the Guardian Angel item

      Type: Passive, Familiar

      Item Pool: Item Room

    *, pink, red

  • Delirious

    ItemID: 510

    "Unleash the power!"

    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: Unlock this item by defeating Delirium for the first time on any character

      Type: Active

      Recharge time: 12 rooms

      Item Pool: Angel Room

    *, yellow, eyes, face, round

  • Angry Fly

    ItemID: 511

    "He's violent"

    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

    UNLOCK: 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

    *, red, cube, wings, face

  • Black Hole

    ItemID: 512

    "Nothing can escape"

    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

    *, pink, purple, black, planet

  • Bozo

    ItemID: 513

    "Party time!"

    +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: Unlock this item by breaking 5 rainbow poops.

      Type: Passive

      Item Pool: Item Room

    *, red, white, stripe, hat, clown, waldo, wally

  • Broken Modem

    ItemID: 514

    "LAG!"

    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 trinket 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

    UNLOCK: Complete 7 Daily Challenges (30 on console)

      Type: Passive

      Item Pool: Shop

    *, black, cube, red, vcr, vhs

  • Mystery Gift

    ItemID: 515

    "Wrapped up nice for you!"

    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

    *, green, red, present, bow, xmas, christmas

  • Sprinkler

    ItemID: 516

    "Sprinkles."

    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

    *, grey, gray, silver, metal, eye, stick

  • Fast Bombs

    ItemID: 517

    "Faster Bomb Drops!"

    +7 Bombs

    Allows you to rapidly place bombs on the ground

    Added as part of the Afterbirth+ Booster Pack #1

    UNLOCK: Unlock this item by defeating Lil Horn 20 times.

      Type: Passive

      Item Pool: Item Room

    *, lightning, bolt, yellow, black

  • Buddy in a Box

    ItemID: 518

    "What could it be?!"

    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

    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

    *, brown, orange, snake, mgs, cardboard

  • Lil Delirium

    ItemID: 519

    "He's Delirious"

    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

    *, white, yellow, eyes, face, circle

  • Jumper Cables

    ItemID: 520

    "Bloody recharge!"

    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: 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

    *, red, black, metal, crocodile, clips

  • Coupon

    ItemID: 521

    "Allow 6 weeks for delivery"

    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

    *, paper, square, green, pink, white, barcode, letter, postcard

  • Telekinesis

    ItemID: 522

    "The power of mind!"

    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

    Has a recharge time of about 2 seconds

    Added as part of the Afterbirth+ Booster Pack #2

      Type: Active

      Recharge time: 2 seconds

      Item Pool: Item Room, Greed Mode Item Room

    *, blue, glow, hand

  • Moving Box

    ItemID: 523

    "Pack and unpack"

    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: Unlock this item by using Pandora's Box in the Dark Room floor.

      Type: Active

      Recharge time: 4 rooms

      Item Pool: Shop

    *, brown, orange, cardboard

  • Technology Zero

    ItemID: 524

    "Static tears!"

    Your tears will now be connected together by beams of electricity which deals damage to enemies they hit

    Added as part of the Afterbirth+ Booster Pack #2 and based on the Steam Workshop mod created by Ashkait and Scayze

    UNLOCK: Unlock this item by having 2 technology items at once.

      Type: Passive

      Item Pool: Item Room, Greed Mode Item Room

    *, black, white, grey, gray, round, circle, eye, key, hole, coin, slot, laser

  • Leprosy

    ItemID: 525

    "You're tearing me apart!"

    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

    *, lepracy, leprasy, leprosy, pink, red, bloody, lump

  • 7 Seals

    ItemID: 526

    "Lil Harbingers!"

    Gives you a random Harbinger familiar that changes every 10 seconds.

    Each harbinger behaves differently, based on any of the original 5 horsemen bosses

    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

    *, bloody, paper, script, white, red, toilet paper

  • Mr. ME!

    ItemID: 527

    "Caaan Do!"

    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: Unlock this item by opening 20 locked chests.

      Type: Active

      Recharge time: 4 rooms

      Item Pool: Shop

    *, mr me!, Mr Meeseeks, rick and morty, brown, chest, szechuan sauce

  • Angelic Prism

    ItemID: 528

    "Eclipsed by the moon"

    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

    *, dark side of the moon, rainbow, red, yellow, green, white, triangle, pink floyd, thought

  • Pop!

    ItemID: 529

    "Eyeball tears!"

    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

    *, eyes, eyeball, bloody, white, red, googly googley, bank shot

  • Death's List

    ItemID: 530

    "Just hope you're not next"

    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

    *, parchment, quill, script, pact, feather, scroll

  • Haemolacria

    ItemID: 531

    "I'm seeing red..."

    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: Unlock this item by picking up the Blood Clot item 10 times.

      Type: Passive

      Item Pool: Item Room

    *, water balloon, blood, heamolacria

  • Lachryphagy

    ItemID: 532

    "Feed them!"

    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

      Type: Passive

      Item Pool: Item Room

    *,

  • Trisagion

    ItemID: 533

    "Smite thy enemy"

    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

      Type: Passive

      Item Pool: Angel Room

    *,

  • Schoolbag

    ItemID: 534

    "Extra active item room"

    Gives you an extra active item slot

    Pressing the CTRL key allows you to switch active items

    Functions exactly the same as the Antibirth item with the same name

    Added as part of the Afterbirth+ Booster Pack #4.

    UNLOCK: Unlock this item by entering every Shop from the first floor up to Mom's Heart (Depths 2).

      Type: Passive

      Item Pool: Shop

    *,

  • Blanket

    ItemID: 535

    "You feel safe"

    +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

    Added as part of the Afterbirth+ Booster Pack #5. Based on the Steam Workshop mod created by Ratlah

    UNLOCK: Unlock this item by sleeping in 10 different beds.

      Type: Passive

      Item Pool: Shop

    *,

  • Sacrificial Altar

    ItemID: 536

    "He demands a sacrifice"

    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: Curse Room

    *, sacraficial, sacrafice

  • Lil Spewer

    ItemID: 537

    "Puking buddy"

    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: 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"

    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: Unlock this item by using 5 Gulp! pills in one run.

      Type: Passive

      Item Pool: Boss Room

    *,

  • Mystery Egg

    ItemID: 539

    "Sacrificial insemination"

    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: Unlock this item by spawning 3 charmed enemies in a single room.

      Type: Passive

      Item Pool: Item Room

    *,

  • Flat Stone

    ItemID: 540

    "Skipping tears"

    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: 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?"

    +1 Bone Heart

    Spawns 3 red hearts on the ground when picked up

    Added as part of the Afterbirth+ Booster Pack #5.

    UNLOCK: 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"

    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: 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"

    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.

    UNLOCK: Unlock this item by defeating Hush as The Forgotten.

      Type: Passive

      Item Pool: Item Room, Greed Mode Item Room

    *,

  • Pointy Rib

    ItemID: 544

    "Stabbing time"

    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: 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"

    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.

    UNLOCK: Unlock this item by defeating Delirium in The Void floor as The Forgotten.

      Type: Active

      Recharge time: 4 rooms

      Item Pool: Item Room, Library, Devil Room

    *,

  • Dad's Ring

    ItemID: 546

    "Father's blessing"

    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: 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"

    +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: Unlock this item by defeating Boss Rush as The Forgotten.

      Type: Passive

      Item Pool: Boss Room

    *,

  • Jaw Bone

    ItemID: 548

    "Fetch"

    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: 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"

    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: 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"

    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"

    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"

    When used, spawns a trapdoor that leads to the next floor (has a 10% chance to be a crawl space instead)

    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

  • Swallowed Penny

    TrinketID: 1

    "Gulp!"

    Each time you get hit, you drop a coin or two.

    UNLOCK: Unlock this item by beating Challenge #15 (Slow Roll).

    * , the lost item pool, cent, gold, water, wet, blue

  • Petrified Poop

    TrinketID: 2

    "It feels lucky?"

    While held, Isaac has a significantly higher chance to find drops when breaking poops.

    *, grey, gray

  • 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.

    *, bullet, grey, gray, yellow

  • 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).

    *, joystick, grey, gray

  • 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.

    *, red

  • 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).

    *, red, black, circle

  • 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.

    * , the lost item pool, nes, game, grey, gray

  • 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.

    *, white, lump

  • Wiggle Worm

    TrinketID: 10

    "Wiggle wiggle!"

    Tears now move in a wave fashion across the room.

    Tears up (not applied until the next time your tears stat is updated).

    *, white, s, snake

  • Ring Worm

    TrinketID: 11

    "Woop woop!"

    While held, tears move in a spiral pattern across the screen at high speed.

    Effectively increases your range due to the tear pattern.

    *, white, circle, snake

  • Flat Worm

    TrinketID: 12

    "Blub blub!"

    Tears become flat and disc shaped giving them a larger hitbox.

    Higher knockback effect with your tears.

    *, grey, gray, eyes

  • 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: Unlock this item by beating the Chest with Lazarus.

    *, grey, gray, dollar, bill, note, cash, money

  • Callus

    TrinketID: 14

    "Your feet feel stronger"

    Isaac no longer takes damage from walking over spikes and blood creep while this trinket is held.

    * , the lost item pool, brown, pink, lump, ball, spot

  • Lucky Rock

    TrinketID: 15

    "There's something inside"

    Rocks now drop money when broken.

    UNLOCK: Unlock this item by destroying 100 rocks.

    *, grey, gray, stone, square

  • Mom's Toenail

    TrinketID: 16

    "???"

    Mom's Leg will now appear every 60 seconds and stomp down randomly in the room dealing 300 damage to enemies, similar to how Daddy Longlegs works but less frequent.

    Be warned though, Mom's leg can also stomp and hurt Isaac too!

    *, mustache, moustache, white, yellow

  • Black Lipstick

    TrinketID: 17

    "Evil up"

    Increases the chance for Black hearts to spawn.

    UNLOCK: Unlock this item by beating the Dark Room with Eve.

    * , the lost item pool, grey, gray, makeup

  • 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.

    * , the lost item pool, grey, gray, black, book

  • Paper Clip

    TrinketID: 19

    "Master of lockpicking"

    Allows you to unlock golden chests without needing a key.

    Does not work on locked rooms.

    In Afterbirth Cain starts with this trinket after donating 68 coins to the Greed Donation Machine.

    * starting, grey, gray, metal, wire

  • Monkey's 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.

    * , the lost item pool, hand, brown

  • 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: Unlock this item by beating the Chest with Eden.

    *, white, grey, gray, page

  • Daemon's Tail

    TrinketID: 22

    "Evil up"

    When Daemon's Tail is held, most future Heart drop will be rerolled into something else, with a certain chance to be rerolled into a Black Heart.

    Every type of heart will be affected (except for hearts spawned in Super Secret Rooms) and causes Mitre, Bible Tract, Mom's Pearl to become useless.

    Upon entering a new room that already has hearts on the ground, they will all be converted into Black Hearts.

    Hearts that spawn after clearing a room, opening a chest or playing a slot machine/beggar will be re-rolled into another possible pickup that could appear. This essentially means you are sacrificing your heart drops for a higher chance of all other pickups

    UNLOCK: Unlock this item by beating Satan with Azazel.

    *, black, devil, pointy

  • Missing Poster

    TrinketID: 23

    "???"

    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'.

    UNLOCK: Unlock this item by beating Dark Room with Isaac.

    In Afterbirth dying with this trinket causes you to respawn as The Lost character and dying in a sacrifice room while holding this trinket will now unlock the Lost character.

    *, page, paper, isaac, white, writing

  • Butt Penny

    TrinketID: 24

    "Wealth of gas"

    Everytime you pick up a coin, you fart.

    *, brown, orange, flat

  • Mysterious Candy

    TrinketID: 25

    "Uh-oh!"

    Causes Isaac to create poops randomly.

    *, chocolate, brown, rectangle

  • Hook Worm

    TrinketID: 26

    "Zip zoop!"

    Tears now move forwards at right angles, shifting left and right across the room.

    Increases your range stat by +10.0 while held but due to the fire pattern, your tears travel a similar distance to normal.

    *, white, snake, square

  • 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.

    *, snake, white

  • Broken Ankh

    TrinketID: 28

    "Eternal life?"

    Has a 22.22% chance to respawn with 3 Soul hearts as Blue Baby when you die.

    UNLOCK: Unlock this item by beating Satan with Lazarus.

    *, ank, grey, gray

  • Fish Head

    TrinketID: 29

    "It stinks"

    Everytime Isaac takes damage, one blue fly will spawn.

    * , the lost item pool, green, red, bloody, dead

  • 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.

    *, red

  • 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.

    *, blue

  • 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.

    *, ping, pong, paddle, grey, gray, mushroom

  • Umbilical Cord

    TrinketID: 33

    "Fetal protection"

    If you take damage which leaves you at 1/2 a heart, you gain a Little Steve familiar that follows you and shoots homing tears.

    *, the lost item pool, pink, red, guts, intestine, tube

  • 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.

    * , the lost item pool, red, purple

  • Curved Horn

    TrinketID: 35

    "DMG up"

    +2 Damage Up

    UNLOCK: Unlock this item by beating the Dark Room with Judas.

    *, pink, purple, twisted

  • Rusted Key

    TrinketID: 36

    "It feels lucky?"

    Gives Isaac a higher chance to find keys and chests.

    *, brown, wooden, broken

  • Goat Hoof

    TrinketID: 37

    "Speed up"

    +0.15 Speed Up.

    * grey, gray, bloody, square

  • Mom's Pearl

    TrinketID: 38

    "It emanates purity"

    Grants a secondary chance of any non-specific heart drop turning into a soul heart.

    * , the lost item pool, white, grey, gray, circle, round

  • 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.

    *, green, brown, red, saddle, tube

  • 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.

    *, the lost item pool

  • 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.

    *, red, white

  • Lucky Toe

    TrinketID: 42

    "Luck up!"

    +1 Luck Up while held.

    UNLOCK: Unlock this item by blowing up 20 shop keepers (this includes the ones in the secret room).

    *, finger, thumb, nail, bone

  • Cursed Skull

    TrinketID: 43

    "Cursed?"

    When you take damage while on 1/2 a heart, you are teleported back to the previous room.

    * , the lost item pool, head, bone, grey, gray,

  • Safety Cap

    TrinketID: 44

    "Don't swallow it"

    Gives Isaac a higher chance to find pills.

    *, white, pill

  • 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.

    *, card

  • Isaac's Fork

    TrinketID: 46

    "Consume thy enemy"

    After clearing a room, you have a chance to heal for half a red heart.

    *, the lost item pool, silver, metal, grey, gray

  • 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.

    * , the lost item pool, pink, purple, paper, red

  • Bloody Penny

    TrinketID: 49

    "Wealth of health"

    Everytime you pick up a penny, you have a chance to spawn a red heart on the floor.

    UNLOCK: Unlock this item by beating the Chest with Samson.

    * , the lost item pool, red, coin, cent, money

  • Burnt Penny

    TrinketID: 50

    "Wealth of chaos"

    Everytime you pick up a coin, you have a chance to spawn a bomb on the floor.

    UNLOCK: Unlock this item by beating Challenge #13 (Beans!).

    *, money, silver, grey, gray, steam, smoke, cent

  • Flat Penny

    TrinketID: 51

    "Wealth of answers"

    Everytime you pick up a coin, you have a chance to spawn a key.

    *, white, grey, gray, coin, cent, money, cash

  • Counterfeit Penny

    TrinketID: 52

    "Wealth of wealth"

    When picking up a coin, you have a chance to automatically gain one more coin.

    UNLOCK: Unlock this item by playing the shell game in the arcade 100 times.

    *, yellow, golden, coin, cent, money, cash, sparkle

  • 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 can only be removed by using the Smelter item (Afterbirth+ DLC only) or picking up the Match Stick trinket, meaning you are otherwise unable to take any more trinkets unless you get another item which allows you to hold a second trinket (e.g. Mom's Purse).

    *, insect, bug, spider, beetle, grey, gray, brown

  • 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: Unlock this item by beating the Boss Rush with Isaac.

    *, dead, crying

  • Maggy's Faith

    TrinketID: 55

    "Faith's reward"

    At the start of a new floor, you get an eternal heart.

    UNLOCK: Unlock this item by beating the Dark Room with Maggy.

    * , the lost item pool, cross, yellow, golden, glow

  • 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: Unlock this item by beating Satan with Judas.

    * , the lost item pool, tong, red, bloody, lips

  • ???'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: Unlock this item by beating the Dark Room with Blue Baby.

    *, dead, baby, blue

  • 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: Unlock this item by beating the Dark Room with Samson.

    *, hair, pony, tail, brown, red

  • 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: Unlock this item by beating the Chest with Cain.

    *, circle, white, black

  • 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: Unlock this item by beating the Isaac boss with Eve.

    *, grey, gray, black, striped

  • The Left Hand

    TrinketID: 61

    "The left hand path reaps dark rewards"

    Replaces chest spawns with red chests.

    UNLOCK: Unlock this item by beating Ultra Pride.

    * northernlion, drop the left hand, paw, bloody, bleeding, grey, gray

  • 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.

    *, grey, gray, silver, lump, metal, stone

  • 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.

    *, blue, metal, sissors

  • 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

    *, lgbt, circle, snake, red, green, blue

  • Tape Worm

    TrinketID: 65

    "Floooooooooop!"

    While held, Tape Worm doubles your range stat and halves your tear height stat.

    *, intestine, white, snake

  • Lazy Worm

    TrinketID: 66

    "Pft"

    -0.4 Shot Speed Down.

    +4.0 Range Up.

    +2.0 Tear Height.

    *, circle, button, eyes, white

  • Cracked Dice

    TrinketID: 67

    "You feel cursed... kinda."

    Every time you get hit, you have a chance to activate the D6, D20, D8 or D12 effect.

    UNLOCK: Unlock this item by beating Greed Mode with ???.

    *, stone, rock, grey, gray, white, dice, pip, broken, die

  • 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.

    *, white, grey, gray, pill, medicine, drug

  • 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.

    *, photo, family, old

  • Louse

    TrinketID: 70

    "Itchy, tasty..."

    Gives a small chance to spawn a friendly attack spider while in a hostile room with enemies.

    *, bug, insect, pink, legs

  • 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.

    *, green, bogey, snot, ocarina

  • Watch Battery

    TrinketID: 72

    "Lil charge"

    Gives you an increased chance of finding battery consumables.

    Has a chance to add an extra charge to your active item upon completing a room.

    *, metal, grey, gray, silver, pill, cross

  • Blasting Cap

    TrinketID: 73

    "Pop! Pop!"

    Exploding bombs now have a chance to drop another bomb that you can pick up.

    *, orange, red, circle

  • Stud Finder

    TrinketID: 74

    "The ground below feels hollow..."

    Higher chance to find crawl spaces when exploding rocks.

    UNLOCK: Unlock this trinket by beating Challenge #27 (Brains).

    *, toe, finger, thumb, grey, gray, black, red, yellow

  • 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.

    *, 404, red

  • 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: Unlock this trinket by beating Challenge #26 (I Rule).

    *, red, white, circle, pill, bow

  • Blister

    TrinketID: 77

    "Bounce back!"

    Tears have a stronger knockback effect while this trinket is held

    *, white, lump, circle, hairy

  • 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.

    *, red, stick, dynamite, tnt, rod

  • 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.

    *, grey, gray, black, infinity, oo

  • 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: Unlock this item by beating Greed Mode with Eve.

    *, grey, gray, leaf

  • 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: Unlock this item by beating Blue Womb (Hush) with Samson.

    *, bandana, sling, white, knot, blindfold

  • 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.

    *, yellow, u, magnet

  • Store Key

    TrinketID: 83

    "Stores are open"

    Automatically opens all shop room doors for free.

    UNLOCK: Unlock this trinket by donating 666 coins to the Greed Donation Machine.

    UNLOCK: Keeper starts with this trinket after beating Satan with Keeper.

    * starting, grey, gray, metal

  • 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: Unlock this trinket by beating Ultra Greed with Keeper.

    *, white, trunk, bent

  • 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.

    UNLOCK: Unlock this item by beating The Lamb boss with Keeper.

    *, black, three, spiral

  • Lil Larva

    TrinketID: 86

    "the poop is moving..."

    Destroying poops now gives you a blue fly

    *, white, grey, gray, bent

  • 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.

    *, red, brown, grey, gray, necklace

  • 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.

    *, stop, red, circle, line, cross, entry, warning

  • Child Leash

    TrinketID: 89

    "Keep your friends close..."

    Causes your familiars to stay closer to each other.

    *, ribbon, green, blue

  • Brown Cap

    TrinketID: 90

    "Fartoom!"

    Poop in the environment will now explode when destroyed.

    *, circle, rectangle

  • 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: Unlock this trinket by defeating Greedier Mode with ???.

    *, black, grey, gray, poop

  • Cracked Crown

    TrinketID: 92

    "Boost Stats"

    Gives you extra stat upgrades based on the items you've already collected that have stat increases, at +33% of the item's original increase

    Also gives you a +0.2 Tears Up and -1 Tear Delay even if you don't have an item that increases your tears stat

    *, broken, damaged, yellow, golden

  • 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.

    *, circle, white, fly, brown, poop

  • 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

    *, grey, gray, green, arrow, flower, plant

  • 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

    *, grey, gray, horn

  • Ouroboros Worm

    TrinketID: 96

    "Foop foop!"

    Tears become spectral and travel in a large spiral pattern

    +4.0 Range Up

    *, grey, gray, brown, circle, snake

  • 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

    The Tonsil familiar counts as a passive item but does not appear in any item pools, meaning this trinket is the only way to find it (aside from starting with it as Eden) and make it appear in your Items Collection page.

    *, pink, bloody, brain

  • 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

    *, green, snot, booger, bogey, slime

  • Super Ball

    TrinketID: 99

    "Boing!"

    Some random tears will gain the Rubber Cement effect and become bouncy

    *, yellow, orange, red, circle, stripe

  • 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

    *, yellow, light

  • 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.

    *, grey, gray, light

  • 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

    *, purple, torn, ripped, paper, page, poster

  • 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

    *, red, lines, redpill

  • 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

    *, grey, gray, claw, rib

  • 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

    *, brown, sack, hoof

  • Lost Cork

    TrinketID: 106

    "Uncorked"

    Increases the radius of any creep you produce

    *, brown, yellow, orange, black

  • Crow Heart

    TrinketID: 107

    "Drain me"

    While held, any damage taken will ignore soul hearts and black hearts, causing your red heart containers to be depleted first

    While at 1/2 of a red heart, it will begin to remove your soul hearts and black hearts on damage again.

    UNLOCK: Unlock this item by beating Greedier mode with Eve.

    * crow's, purple, blue, bloody

  • 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

    *, brown, brain, stone, rock

  • 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

    *, grey, gray, tp, toilet, paper, roll, silver

  • Silver Dollar

    TrinketID: 110

    "Feels lucky..."

    While held, shops will now appear on the womb floors (The Womb, Utero and Scarred Womb)

    UNLOCK: Unlock this item by defeating Delirium in The Void floor with Cain.

    *, coin, money, cash, cent

  • Bloody Crown

    TrinketID: 111

    "Drips with blood..."

    While held, item rooms now appear on the womb floors (The Womb, Utero and Scarred Womb)

    UNLOCK: Unlock this item by defeating Delirium in The Void floor with Samson.

    *, red, dripping

  • Pay To Win

    TrinketID: 112

    "..."

    While held, restock boxes will always spawn in item rooms

    *, cent, money, cash, coin, pixel, blue, green, p2w

  • 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: Unlock this trinket by defeating Isaac in the Cathedral as Apollyon.

    *, red, wings, fly, locust of wrath

  • 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: Unlock this item by beating Satan with Apollyon.

    *, green, wings, fly

  • 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: Unlock this trinket by defeating ??? in The Chest as Apollyon.

    *, brown, wings, fly

  • 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: Unlock this trinket by defeating The Lamb as Apollyon.

    *, grey, gray, black, wings, fly

  • 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: Unlock this trinket by defeating Boss Rush as Apollyon.

    *, white, wings, fly

  • 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: Unlock this trinket by defeating Greedier Mode with Azazel.

    *, black, grey, gray

  • Stem Cell

    TrinketID: 119

    "Regen!"

    Heals you for 1/2 a red heart after travelling down to the next floor

    UNLOCK: Unlock this trinket by defeating Greedier Mode with Samson.

    *, red, pink, orange, eye, circle

  • Hairpin

    TrinketID: 120

    "Poke that power outlet! Bosses charge you"

    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

    *, yellow, whip, glow, black

  • 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

    Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Ep and Mills

    *, brown, crucifix

  • 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

    *, yellow, golden, box, block, square, cube

  • 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

    *, silver, grey, gray, white, quill

  • 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

    *, door, stop, wedge, cheese, wood, brown, hodor, game of thrones, Wylis

  • 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: 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: 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 small chance to gain a bone heart everytime you take damage.

    Added as part of the Afterbirth+ Booster Pack #5

    UNLOCK: Unlock this trinket by defeating Ultra Greed as The Forgotten.

    *,

  • Consumables + Misc.

  • O - The Fool

    "Where your journey begins"

    Teleports the player to the first room of the current floor.

    *, tarot, card, green

  • I - The Magician

    "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 purрle appearance.

    *, tarot, card, yellow

  • II - The High Priestess

    "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.

    *, tarot, card, red

  • III - The Empress

    "May your rage bring power"

    Gives the player the Whore of Babylon effect for the current room, increasing damage and speed.

    * speed up, tarot, card, blue, red

  • IV - The Emperor

    "Challenge me!"

    Teleports the player to the Boss room on the current floor.

    *, tarot, card, yellow

  • V - The Hierophant

    "Two prayers for the lost"

    Spawns 2 Soul hearts on the floor.

    *, the lost item pool, tarot, card, blue, red

  • VI - The Lovers

    "May you prosper and be in good health"

    Spawns 2 red hearts on the floor.

    * , the lost item pool, tarot, card, red

  • VII - The Chariot

    "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.

    *, tarot, card, yellow

  • VIII - Justice

    "May your future become balanced"

    Spawns 1 bomb, 1 key, 1 coin, 1 heart, which can be random variants of each.

    *, tarot, card, red

  • IX - The Hermit

    "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.

    *, tarot, card, blue

  • X - Wheel of Fortune

    "Spin the wheel of destiny"

    Spawns a Slot Machine or a Fortune Machine.

    *, tarot, card, pink

  • XI - Strength

    "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.

    *, tarot, card, pink

  • XII - The Hanged Man

    "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.

    * , the lost item pool, tarot, card, grey, gray

  • XIII - Death

    "Lay waste to all that oppose you"

    Deals 40 damage to all enemies in the room in a similar style to the Necronomicon.

    *, tarot, card, grey, gray

  • XIV - Temperance

    "May you be pure in heart"

    Spawns a Blood Donation Machine.

    * , the lost item pool, tarot, card, red, blue

  • XV - The Devil

    "Revel in the power of your darkness"

    Gives the Book of Belial effect for the current room, increasing damage.

    * damage up, tarot, card, red

  • XVI - The Tower

    "Destruction brings creation"

    Spawns some troll bombs at random locations in the current room.

    Each bomb deals 60 damage (normal bomb damage.

    *, tarot, card, purple

  • XVII - The Stars

    "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.

    *, tarot, card, blue

  • XVIII - The Moon

    "May you find all you have lost"

    Teleports the player to the Secret Room.

    *, tarot, card, blue

  • XIX - The Sun

    "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).

    *, tarot, card, yellow

  • XX - Judgement

    "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.

    *, tarot, card, blue

  • XXI - The World

    "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.

    *, tarot, card, pink

  • 2 of Spades

    "Item multiplier"

    Doubles the number of keys you have.

    If you have no keys, it gives you two.

    *, playing, card, white, black

  • 2 of Clubs

    "Item multiplier"

    Doubles the number of Bombs you have.

    If you have no bombs, it gives you two.

    *, playing, card, white, black

  • 2 of Hearts

    "Item multiplier"

    Doubles your current red hearts up to full health.

    This card is useless for the Bluе Baby.

    * , the lost item pool, playing, card, white, red

  • 2 of Diamonds

    "Item multiplier"

    Doubles the number of coins you have.

    If you have no coins, it gives you two.

    *, playing, card, white, red

  • The Joker

    "???"

    Teleports you to the Devil Deal Room on the current floor.

    *, playing, card, white, black

  • Chaos Card

    "???"

    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 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).

    UNLOCK: Unlock this card by beating Challenge #9 (Demo Man).

    In Afterbirth+ this card does not work on the Delirium boss

    *, mtg, card, magic, gathering, brown

  • Credit Card

    "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: Unlock this card by beating Challenge #10 (Cursed!).

    *, blue, green

  • Rules Card

    "???"

    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: Unlock this card by beating Challenge #11 (Glass Cannon).

    *, white, black, writing

  • Card Against Humanity

    "Something stinks..."

    When used, fills the entire room with poop!

    UNLOCK: Unlock this card by beating Challenge #12 (When Life Gives You Lemons).

    *, black, white, writing

  • Suicide King

    "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: Unlock this card by beating Challenge #7 (Suicide King).

    *, white, blue, red

  • Rune of Algiz

    "Resistance"

    When used, gives you an invincibility effect which lasts for 30 seconds (much longer than normal invincibility effects).

    UNLOCK: Unlock this card by beating Challenge #8 (Cat Got Your Tongue).

    *, purple, glow

  • Rune of Ansuz

    "Vision"

    When used, reveals the entire map including all the secret room locations and other icon rooms.

    UNLOCK: Unlock this card by beating Challenge #5 (The Tank).

    *, purple, glow

  • Rune of Berkano

    "Companionship"

    Summons 3 blue friendly spiders and 3 blue flies.

    UNLOCK: Unlock this card by beating Challenge #20 (Purist).

    *, purple, glow

  • Rune of Dagaz

    "Purity"

    Removes the curse which is in effect on the current floor.

    Can also cure the effect of the Amnesia pill.

    +1 Soul Heart.

    UNLOCK: Unlock this card by beating Challenge #4 (Darkness Falls).

    *, purple, glow

  • Rune of Ehwaz

    "Passage"

    Creates a trapdoor on the floor (Same effect as We Need To Go Deeper).

    UNLOCK: Unlock this card by beating Challenge #3 (Head Trauma).

    *, purple, glow

  • Rune of Hagalaz

    "Destruction"

    When used, this rune will destroy all breakable objects in the current room, such as poop, rocks, secret room entrances.

    UNLOCK: Unlock this card by beating Challenge #1 (Pitch Black).

    *, purple, glow

  • Rune of Jera

    "Abundance"

    When used this rune will double all pickups on the floor in the room.

    Creates copies of pickups, even if you haven't purchased them yet.

    Can be used to double the number of golden item chests in the first room of the final Chest floor.

    UNLOCK: Unlock this card by beating Challenge #2 (High Brow).

    *, purple, glow

  • Rune of Perthro

    "Change"

    Rerolls all pedestal items in the current room (One time use of the D6).

    UNLOCK: Unlock this card by beating Challenge #6 (Solar System).

    *, purple, glow

  • 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).

    * pip

  • Blank Rune

    "???"

    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: Unlock this card by beating Challenge #30 (Guardian).

    *

  • Dice Shard

    Gives a one-time use of the D6 and D20 effects at the same time.

    *, purple, broken, pip

  • Get Out Of Jail Free Card

    "Open sesame"

    When used, will open all doors in the current room, similar to a one-time use of Dad's Key.

    UNLOCK: Unlock this card by beating Challenge #22 (Speed).

    *, brown, orange

  • ? Card

    "Double active"

    When used this card will activate a use of your spacebar item for free.

    *, black, white, question, mark

  • Emergency Contact

    "Help from above"

    When used will cause two of Mom's Hand to come down and grab a random enemy.

    *, mom, brown, paper, shop room pool

  • Gold Key

    Once picked up, you gain unlimited key use for the rest of the floor.

    *, yellow, skull

  • Gold Heart

    Once picked up, the gold heart will drop money on the floor the next time Isaac loses a heart.

    UNLOCK: Unlock this item by beating challenge #21 (XXXXXXXXL).

    *, yellow heart, golden heart

  • Bone Heart

    Takes three hits to deplete and can be refilled with red hearts, but disappears forever when depleted

    UNLOCK: Unlock this item by unlocking the Forgotten character. See the Broken Shovel / Mom's Shovel items for more information on how to unlock.

    *, bone heart, white heart

  • Gold Bomb

    Once picked up, you gain unlimited bomb use for the rest of the floor.

    UNLOCK: Unlock this item by beating challenge #23 (Blue Bomber).

    *, yellow

  • Ace of Hearts

    "Convert all"

    When used, turns all pickups and chests in the room into Hearts.

    UNLOCK: Unlock this item by defeating any floor after Basement I with only half a heart of health (works as The Lost).

    *, playing, card, white, red

  • Ace of Spades

    "Convert all"

    When used, turns all pickups and chests in the room into Keys.

    UNLOCK: Unlock this item by defeating The Lamb without taking hearts, coins and bombs.

    *, playing, card, white, black

  • Ace of Clubs

    "Convert all"

    When used, turns all pickups and chests in the room into Bombs.

    UNLOCK: Unlock this item by getting a 3 win streak.

    *, playing, card, white, black

  • Ace of Diamonds

    "Convert all"

    When used, turns all pickups and chests in the room into Coins.

    UNLOCK: Unlock this item by defeating The Lamb in under 20 minutes.

    *, playing, card, white, red

  • Holy Card

    "You feel protected"

    Grants the Holy Mantle effect for one room, which will negate your next hit of damage

    UNLOCK: Unlock this item by defeating Delirium in The Void floor with The Lost.

    *, playing, card, white, cross, blue

  • Black Rune

    "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: Unlock this item by beating Greedier mode as Apollyon.

    *, rock, black

  • Huge Growth

    "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: Unlock this item by getting 5 items or consumables that increase your size, e.g. 'One Makes you Larger' pills, Magic Mushroom etc.

    *, mtg, card, magic, gathering, green, brown, giant growth

  • Ancient Recall

    "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

    *, mtg, card, magic, gathering, blue

  • Era Walk

    "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: Unlock this item by getting both the Broken Watch and the Stop Watch in your collection

    *, mtg, card, magic, gathering, blue

  • Rebirth Pills A - L (Page 1 of 2)

    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

    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 (Page 2 of 2)

    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

    *