Isaac Afterbirth+ MEGA GUIDE!

Overview

Item list / Trinkets / Transformations / Seeds

Update

Guide will be updated soon

Activated Collectibles

Name

Icon

Quote

Description

Recharge

The Bible

Temporary Flight

Upon activation, Isaac gains flight, allowing him to pass over all obstacles in the current room. Instantly kills Mom, Mom’s Heart, and It Lives when activated, but will kill Isaac when activated while fighting Satan.

The Book of Belial

Temporary DMG up

Upon use increases damage by 2 for the current room and by a further +50% if the character also has the Blood of the Martyr. Guarantees a Devil Room or Angel Room will be open after beating a boss while holding it.

Increases the chance for a Devil or Angel Room to appear by 12.5%.

The Necronomicon

Mass room damage

Damages all enemies in the room significantly.

The Poop

Plop!

Spawns a pile of poop where the character is standing and knocks nearby monsters back. May yield pickups like regular poop.

Mr. Boom

Reusable bomb buddy

Drops a large bomb.

Tammy’s Head

Reusable tear burst

Shoots 10 tears in a circle around Isaac, which retain the damage, shot speed, and special effects (such as poison) of Isaac’s tears.

Mom’s Bra

Mass Fear

Upon use, petrifies all enemies in the current room for approximately 4 seconds.

Kamikaze!

Become the bomb!

Creates an explosion in the same area as Isaac, dealing half a heart of damage to him and also damaging all enemies caught in the blast radius.

Mom’s Pad

Gross…

Upon use, inflicts fear to all enemies in the room for 5 seconds.

Bob’s Rotten Head

Reusable ranged bomb

Upon use, Isaac holds a poison bomb which can be thrown towards any of the four cardinal points and explodes on impact.

Teleport

Teleport!

Teleports you to a random room on the level.

Yum Heart

Reusable Regeneration

Restores 1 whole red heart.

Doctor’s Remote

Reusable Air Strike

Sets a big red target on the ground which can be controlled with tear controls. After 6 seconds or by pressing space again, a huge explosive missile hits it, which damages all enemies caught in its blast radius.

Shoop Da Whoop!

BLLLARRRRGGG!

Fires a laser from Isaac’s mouth.

Lemon Mishap

Oops

Creates a small yellow pool of creep, which damages enemies that cross it.

Book of Shadows

Temporary Invincibility

Upon use, creates a protective shield nullifying all types of damage for 10 seconds.

Anarchist Cookbook

Summon bombs

Spawns six troll bombs around the room.

The Hourglass

Temporary enemy slowdown

Upon activation, enemies and their projectiles are slowed down for a short duration.

My Little Unicorn

Temporary badass

Upon use, grants invulnerability and increased speed for five seconds, removing the ability to shoot tears and replacing it with the ability to deal contact damage to enemies.

Book of Revelations

Reusable soul protection

Adds 1 soul heart, increases the chance for a Devil or Angel Room to appear, and increases the chance for the next boss to be a Horseman (except on XL floors and floors with fixed bosses such as Mom).

The Nail

Temporary demon form

Adds one soul heart and allows the breaking of Rocks and damaging enemies by simply walking over them. Increases Damage and decreases Speed. All effects except for the Soul Heart wear off upon leaving the room.

We Need to Go Deeper!

Reusable level skip

Creates a trapdoor to go to the next floor. If used in The Womb, it will create a trapdoor to Sheol, even if the player hasn’t unlocked it.

Deck of Cards

Reusable Card Generator

Gives Isaac a random Tarot Card.

Monstro’s Tooth

Summon Monstro

Monstro jumps onto a random enemy, doing area damage. Can damage/kill the player if summoned in an room without enemies.

The Gamekid

Temporary Man-Pac

Upon use, turns the character into a into a Pac-Man-like creature for 5 seconds, granting invulnerability, inflicting fear on all enemies, and replenishing half a red heart container for every two enemies killed.

The Book of Sin

Reusable Item Generator

Spawns a random pickup, pill, card, or trinket.

Mom’s Bottle of Pills

102

Reusable pill generator

Gives Isaac a random pill, and will cause him to drop any held Q-slot item (If any). The player will only receive six different pill types in one playthrough.

The D6

105

Reroll Your Destiny

Allows Isaac to re-roll collectible items in the current room into other items, depending on the current room’s Item Pool.

The Pinking Shears

107

Cut and Run

Separates Isaac’s head and body for the current room. Isaac’s head, which now has flight, will be under the player’s control, while his body will seek out enemies to attack by contact damage.

The Bean

111

Toot on command

Isaac releases bad gas, poisoning any enemy in close vicinity.

Monster Manual

123

Temporary buddy generator

Summons a random familiar for the current room. Can summon familiars not yet unlocked.

Dead Sea Scrolls

124

It’s a mystery

Triggers the effect of a random activated item from a list of possible options (not every activated item is included).

Razor Blade

126

Feel my pain

Upon use deals one heart damage and grants +1.2 damage for the current room.

Forget Me Now

127

I don’t remember

When activated, the level ends and is freshly regenerated with new rooms, monsters, and items. Disappears after use.

One time use

The Pony

130

Flight + Dash Attack

Passively grants flight and increased speed. Upon use, Isaac charges in the direction the pony is facing, becoming invulnerable during the charge and damaging enemies.

Guppy’s Paw

133

Soul converter

Removes one Heart Container in exchange for gaining 3 Soul Hearts.

IV Bag

135

Portable blood bank

Upon activation, Isaac loses a half-heart (one whole heart in The Womb onwards) for a random amount of coins, similar to the blood donation machine.

Best Friend

136

Friends ’till the end

Deploys a decoy Isaac that eventually explodes with an increased blast radius.

Remote Detonator

137

Remote bomb detonation

Bombs you place explode only when you use this item. Gives 5 bombs.

Guppy’s Head

145

Reusable fly hive

Spawns 2-4 blue flies to damage enemies.

Prayer Card

146

Reusable eternity

Grants an eternal heart per use.

Notched Axe

147

Rocks don’t stand a chance

Isaac holds the axe above his head for as long as the spacebar button is held (or until he leaves the room). While holding the axe, Isaac can break any rock he touches, but cannot attack or pick up other items.

Crystal Ball

158

I see my future

Reveals the map (except the Super Secret Room) and drops a random Tarot Card or soul heart.

Crack the Sky

160

Holy white death

Summons multiple beams of light in random locations around the room, dealing a large amount of damage to any enemy that touches them.

The Candle

164

Reusable flame

Throws out a blue flame that can pass over gaps (but not through rocks). The flame damages anything in its path.

4 seconds

D20

166

Reroll the basics

Rerolls all pickups in the current room.

Spider Butt

171

Mass enemy slowdown + damage

Damages all enemies in the room and slows them and their projectiles down.

Dad’s Key

175

Opens all doors…

Opens all doors in the current room when activated, including doors which require a key to open and entrances to secret rooms. Opens the big doors in the first room of both The Chest and the Dark Room.

Portable Slot

177

Gamble 24/7

Upon activation, 1 coin will be consumed, and a random pickup may drop, similar to the slot machine.

White Pony

181

Flight + holy death

Passively grants flight and increased speed. 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.

Blood Rights

186

Mass enemy damage at a cost

Damages all enemies in the room, but deals a heart of damage to Isaac with each use.

Telepathy for Dummies

192

Temporary psychic shot

Upon activation, grants homing tears for the current room.

How to Jump

282

It’s about time you learned how

Gives Isaac the ability to jump (over gaps, spikes, etc.).

D100

283

REEROLLLLL!

Upon use, rerolls all passive items on Isaac like the D4, every pedestal item in the room like The D6 and every pickup like the D20.

284

Reroll into something else

Rerolls all of Isaac’s items

D10

285

Rerolls enemies

Rerolls the enemies in a room. Only rerolls enemies that are still alive (does not spawn new enemies).

Blank Card

286

Card Mimic

Has the same effect as the card or rune currently held by Isaac.

Book of Secrets

287

??????

Upon use, gives the effect of Treasure Map, The Compass, or Blue Map for the duration of the current floor.

Box of Spiders

288

It’s a box of spiders

Summons 2-4 blue spiders.

Red Candle

289

Flame on

Throws a persistent flame that deals high damage and diminishes as it damages enemies or blocks shots.

4 seconds

The Jar

290

Save your life

When at full health, up to 4 extra hearts can be stored in the jar.

Flush!

291

…

Changes all enemies in the room into poop. Does not work on all enemies (Knights and bosses are immune). Instantly kills Dingle, Dangle, and Brownie.

Satanic Bible

292

Reusable Evil

Upon activation, Isaac gains a black heart.

Head of Krampus

293

Krampus Rage

Fires a cross-patterned brimstone shot, just like The Fallen and Krampus shoot.

Butter Bean

294

Reusable knock-back

Isaac farts and pushes back nearby enemies.

3 seconds

Magic Fingers

295

Pay to play

For 1 Coin, damages all enemies in the room.

Converter

296

Convert your soul

When used, converts two soul hearts into a heart container.

Pandora’s Box

297

Upon use, spawns certain pickups or items depending on the floor it is used on. Single-use.

One time use

Unicorn Stump

298

You feel stumped

Upon use, grants invulnerability and increased speed for five seconds, but removes the ability to shoot tears.

Isaac’s Tears

323

Collected tears

Shoots 8 tears around Isaac, which retain the damage, shot speed, and special effects of his tears. Each tear shot by Isaac increases item charge by one.

Undefined

324

Undefined

Teleports Isaac to either the Secret Room, Super Secret Room, Treasure Room, or I AM ERROR.

Scissors

325

Lose your head

Upon use, turns Isaac’s head into a stationary familiar for the current room which fires normal tears that deal 3.5 damage.

Breath of Life

326

Invincibility at a cost

Grants a brief moment of invincibility when the charge bar hits zero. If spacebar is held for an additional second after hitting zero, Isaac will take damage.

6; 1 per second

The Boomerang

338

It will never leave you

Throws a short-range boomerang which does a bit of damage and has a high chance to stun the enemy for 2 seconds. Can also be used to grab pickups.

4 seconds

Diplopia

347

Double item vision

Duplicates all pickups and item pedestals in the room.

One time use

Placebo

348

Pill mimic

When used, copies the effect of the pill Isaac is currently holding without consuming it. Does not copy the effects of cards or runes.

Wooden Nickel

349

Flip a coin

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

Mega Bean

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 near Isaac, and send a wave of spikes that deals 10 damage across the room in the direction Isaac is facing.

Glass Cannon

352

Be gentle…

When used, reduces Isaac’s health to half a heart (including soul and black hearts) and fires one large piercing spectral tear that does a lot of damage. The damage done by Glass Cannon scales with Isaac’s damage (at base damage it does 45 damage).

4 seconds

Box of Friends

357

Double your friends

Upon use, duplicates all of Isaac’s familiars for the current room.

Friendly Ball

382

Gotta fetch ’em all!

Throwing the ball at an enemy instantly kills it and captures it. The captured enemy can later be released and will be charmed until it dies, persisting between floors.

Tear Detonator

383

Remote tear detonation!

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

D12

386

Rerolls rocks

Re-rolls all rocks in the current room into other random objects, such as bomb rocks, metal blocks, TNT, or poops.

Ventricle Razor

396

Short cutter

Can be used to place an orange portal and a blue portal. Upon entering a portal, Isaac is teleported to the other portal.

406

Reroll stats

Re-rolls Isaac’s speed, range, tears and damage.

Teleport 2.0

419

I-Teleport!

When used, teleports Isaac to a random room that has not been explored yet. If all rooms are explored, including secret rooms, it will teleport Isaac to the Devil or Angel room. If all rooms are explored, including the Devil or Angel room, it will teleport Isaac to the I AM ERROR room. If used in a room with enemies, it will teleport Isaac out and back into the exact same room.

Kidney Bean

421

Love toots!

Upon use, Isaac farts, charming all nearby enemies.

Glowing Hour Glass

422

Turn back time

When used, this item will rewind time, put Isaac back in the previous room, and undo anything that happened in the current room. Any health, pickups, or items gained or lost will be reset back to the previous state.

Mine Crafter

427

Booom!

When used, places an explosive TNT barrel that can be pushed and used to destroy rocks or damage enemies. If used a second time in the same room while the previous TNT barrel is still intact, it will remotely explode the TNT.

Jar of Flies

434

Gotta catch ’em all?

Every time Isaac kills an enemy, a fly will be added to the jar, up to a maximum of 20. Using the Jar of Flies will release all the flies that are currently in the jar as friendly blue flies that will damage enemies.

437

Reroll rewards!

Restarts the current room and brings back all enemies, allowing more rewards to be acquired by completing the room.

Mom’s Box

439

What’s inside?

When used, Mom’s Box will drop a random trinket on the ground. While held, increases luck by 1 and doubles the effects of trinkets.

Mega Blast

441

Laser breath

Upon use, Isaac fires a laser similar to the one used by Mega Satan. This laser deals massive damage, lasts for approximately 15 seconds, and persists between rooms. Isaac is pushed backwards by the force of the laser while it is active.

Plan C

475

Use with caution

Kills all enemies in the room, then kills Isaac three seconds later.

One time use

476

What will it be?

Duplicates a random pickup in the room.

Void

477

Consume

Consumes all pedestal items in the room. Active items will have their effects added to Void, and passive items will grant stat upgrades.

Pause

478

Stop!

Freezes all enemies until a fire button is pressed.

Smelter

479

Trinket melter!

Consumes Isaac’s currently held trinket and applies its effect permanently.

Compost

Gain more friends!

Spawns a blue spider or fly. Turns pickups in the room into blue spiders or flies.

Dataminer

481

109

Displaces enemy sprites for the current room and increases or decreases a random stat.

Clicker

482

Change

Transforms Isaac into another random character.

Mama Mega!

483

BOOOOOOOOOM!

Damages all enemies and destroys all obstacles. The effect occurs every time a new room is entered for the rest of the floor. Opens doors to the floor’s secret and super secret rooms.

One time use

Wait What?

484

I can’t believe it’s not Butter Bean!

Isaac farts, sending out rock waves.

10 seconds

Crooked Penny

485

50/50

Spawns a penny and has a 50% chance to double all items and pickups in the room. If the effect fails, the items and pickups disappear.

Dull Razor

486

I feel numb…

Hurts Isaac without depleting health, activating any items that trigger upon taking damage.

Potato Peeler

487

A pound of flesh

Removes a heart container, increases damage and range, and grants a Cube of Meat.

Metronome

488

Waggles a finger

Grants a random item effect for the current room.

D Infinity

489

Reroll forever

Grants a random dice item that changes each use.

Eden’s Soul

490

…

Spawns two item pedestals.

12, one time use

Brown Nugget

504

Friendly fly

Spawns a stationary fly familiar that fires tears at nearby enemies.

7 seconds

Sharp Straw

507

More blood!

Damages all enemies in the room.

8 seconds

Delirious

510

Unleash the power!

Spawns a random charmed boss.

Black Hole

512

Nothing can escape

Throws a black hole on the ground which sucks in and damages enemies.

Mystery Gift

515

Wrapped up nice for you!

Upon use, spawns a random item from the current room’s item pool, with a chance to spawn A Lump of Coal or The Poop instead.

One time use

Sprinkler

516

Sprinkles.

Upon use, spawns a sprinkler that rotates and fires tears.

Coupon

521

Allow 6 weeks for delivery

Upon use, makes a random item from a shop, devil deal, or black market free.

Telekinesis

522

The power of mind!

Upon use, for the next two seconds, any enemy shots that come near Isaac are held in place. After the charge is depleted, they are fired back as tears.

3 seconds

Moving Box

523

Pack and unpack

If the box is empty, picks up all items and pickups in a room and stores them. If the box is not empty, places all stored items and pickups in the current room.

Mr. ME!

527

Caaan Do!

Summons a controllable ghost that can perform various tasks depending on what it targets.

Passive Collectibles

Name

Icon

Quote

Description

The Sad Onion

Tears up

Increases Tears by 0.7.

The Inner Eye

Triple shot

Grants triple shot but decreases tears.

Spoon Bender

Homing shots

Grants Isaac homing tears.

Cricket’s Head

DMG up

Increases damage by 0.5, and multiplies it by 1.5x.

My Reflection

Boomerang tears

Gives Isaac’s tears a boomerang effect, and increases range and shot speed.

Number One

Tears up

Tears range is heavily decreased, but the fire rate is greatly increased.

Blood of the Martyr

DMG up

Increases Damage by 1, and turns Isaac’s tears into blood tears.

Brother Bobby

Friends ’till the end

Follows Isaac around shooting normal tears.

Skatole

Fly love

All types of fly except Boom Fly and Red Boom Fly become passive and slowly move towards Isaac. Does not prevent contact damage.

Halo of Flies

Projectile protection

Spawns two pretty fly familiars that block enemy shots and deal contact damage to enemies.

1up!

Extra life

Gives an extra life. Upon death, you will respawn in the previous room with full health and lose the 1up!.

Magic Mushroom

All Stats Up!

Increases all stats and enlargens Isaac.

The Virus

Poison touch

Inflicts poison to enemies who make contact with Isaac. Speed down.

Roid Rage

Speed and range up

Increases speed by 0.6, range by 5.25, and tear height by 0.5.

HP up

Increases available heart containers by 1 and restores all health.

Raw Liver

HP up

Grants 2 Heart Containers and completely restores health.

Skeleton Key

99 keys

Sets your key count to the maximum of 99.

A Dollar

$$$

Gives Isaac 99 coins. Can be found multiple times in a single playthrough.

Boom!

10 bombs

Gives 10 bombs.

Transcendence

We all float down here…

Grants flight.

The Compass

The end is near

Reveals all special rooms (except secret rooms of any kind).

Lunch

HP Up

Adds 1 heart container.

Dinner

HP Up

Adds 1 heart container.

Dessert

HP Up

Adds 1 heart container.

Breakfast

HP up

Adds 1 heart container.

Rotten Meat

HP up

Adds one heart container.

Wooden Spoon

Speed up

Increases speed by 0.3.

The Belt

Speed up

Increases speed by 0.3.

Mom’s Underwear

Range up

Increases range.

Mom’s Heels

Range up

Increases range.

Mom’s Lipstick

Range up

Increases range and shot height.

Wire Coat Hanger

Tears up

Increases Tears by 0.7.

Lucky Foot

Luck up

+1 Luck. Increases chance of winning Shell Game Beggar. (Independent of luck stat)

Cupid’s Arrow

Piercing shots

Grants Isaac piercing tears that travel through enemies (but not obstacles) instead of breaking on impact with them.

Steven

DMG up

Increases Damage by 1.

Pentagram

DMG up

Increases damage and increases the chance for a Devil or Angel Room to appear.

Dr. Fetus

???

Tears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.

Magneto

Item snatcher

Pulls pickups towards Isaac.

Treasure Map

Full visible map

Reveals all rooms for every floor. However, it does not reveal icons or secret rooms.

Mom’s Eye

Eye in the back of your head

Allows Isaac to fire tears from the back of his head.

Distant Admiration

Attack fly

A red attack fly circles further out than the Halo of Flies / Pretty Flies, but closer than Forever Alone. Deals more damage than Forever Alone.

The Ladder

Building bridges

Allows Isaac to walk across gaps one square across by automatically placing a ladder between the two walkable sections.

Charm of the Vampire

Kills heal

Heals the character for half of a red heart for every 13 monsters killed.

The Battery

Stores energy

Activated Items can be “overcharged” to allow for an additional use.

Steam Sale

50% off

Reduces all Shop prices by 50%, rounded down to 7 coins for an item, rounded up to 2-3 coins for a pickup.

Sister Maggy

Friends ’till the end

A familiar that follows Isaac around shooting blood tears.

Technology

Laser tears

Replaces tears with a piercing laser with unlimited range.

Chocolate Milk

Charge shots

Grants charged tears that deal greater damage when fully charged.

Growth Hormones

Speed + DMG up

Increases damage by 1 and speed by 0.4.

Mini Mush

Speed + range up

Increases Speed and Shot Height and decreases Isaac’s size, but lowers Range.

Rosary

Faith up

Adds 3 Soul Hearts and increases the chance for The Bible to appear in any item pool.

Cube of Meat

Gotta meat ’em all!

Orbiting familiar that blocks enemy shots and deals damage to enemies. If collected while already having one, makes the familiar evolve. Only drops from Horsemen. Similar to Ball of Bandages.

A Quarter

+25 coins

Adds 25 to Isaac’s coin count, capping at 99.

X-Ray Vision

I’ve seen everything

Reveals and opens all Secret Room and Super Secret Room entrances.

The Mark

DMG up

Increases Damage and Speed, plus adds one Soul Heart.

The Pact

DMG + Tears UP

Increases damage by 0.5, tears by 0.7 and grants two soul hearts upon pickup.

Dead Cat

9 lives

Sets the amount of red heart containers to 1, but gives Isaac 9 extra lives. After dying, Isaac is teleported to the last safe room. New heart containers can be obtained after picking up this item, but after each death, the number of heart containers is set to 1 again.

Lord of the Pit

Demon wings

Grants flight and increases speed.

Loki’s Horns

Cross Tears

Gives a random chance for projectiles to fire in all 4 cardinal directions.

Little Chubby

Attack Buddy

A familiar that charges forward and deals touch damage to any enemies in its path.

Spider Bite

Slow effect

Adds a chance to shoot slowing tears, reducing speed of enemy movement and any projectile fired by them.

The Small Rock

DMG up

Increases damage by 1, increases tears by 0.2, and decreases speed by 0.1.

Spelunker Hat

See-through doors

Reveals type of adjacent rooms, including location for secret rooms and super secret rooms.

Super Bandage

+2 hearts

Grants one Heart Container and gives 2 Soul Hearts.

Sack of Pennies

Gives money

Isaac is followed by a small bag that drops a coin every 2 rooms.

Robo-Baby

Friends ’till the bbbbzzzt

Follows Isaac around, shooting enemies with an eye laser similar to Technology.

Little C.H.A.D.

Gives kisses

A familiar who will drop a half Heart every 2 rooms.

The Relic

Soul generator

Isaac is followed by a small blue cross that will drop a Soul Heart every 4 rooms.

Little Gish

Sticky friend

Spawns a familiar that follows Isaac around and fires slowing tears, impeding enemies’ speed.

Little Steven

100

Psychic friend

Spawns a familiar that follows Isaac around and fires homing tears.

The Halo

101

All stats up

Grants one Heart Container, +0.3 Damage, +0.2 Tears, +0.25 Range, +0.3 Speed, and +0.5 Tear Height.

The Common Cold

103

Poison Damage

Adds a chance to shoot poison tears, dealing damage over time when inflicted.

The Parasite

104

Split Shot

Isaac’s tears split in two when they hit something.

Mr. Mega

106

Blast damage

Gives Isaac 5 bombs, and makes all dropped bombs larger, which have an increased blast radius and increased damage.

The Wafer

108

Damage resistance

All sources of damage that would cause more than one half heart of damage are reduced to one half heart instead.

Money = Power

109

$$$ = DMG

Increases damage by 0.04 for every coin Isaac has up to +3.96 damage at 99 coins.

Mom’s Contacts

110

Freeze effect

Adds a chance to shoot petrifying tears, which stop enemies in place and prevent them from moving or attacking. Range up.

Guardian Angel

112

Extra protection

Spawns an orbital familiar that blocks enemy projectiles, deals contact damage to enemies and increases the speed of all orbital familiars.

Demon Baby

113

Auto-turret friend

Follows Isaac and automatically fires at enemies in its reach.

Mom’s Knife

114

Stab stab stab

Isaac’s tears are replaced by a knife that pierces enemies, can travel through obstacles, and can hurt enemies while Isaac is holding it. Holding down the fire button before firing increases its range and power.

Ouija Board

115

Spectral tears

Grants spectral tears that travel through obstacles (but not enemies) instead of breaking on impact with them.

9 Volt

116

Quicker charge

Reduces the charge of any Activated Items by 1. Any 1 charge items instead have timed recharges.

Dead Bird

117

Protective buddy

Spawns a flying familiar for the current room that chases enemies whenever Isaac takes damage.

Brimstone

118

Blood laser barrage

Tears are replaced by a laser beam that pierces through all enemies and obstacles in its path and deals high damage. Can only be fired after a short charge-up period.

Blood Bag

119

HP up

Grants 1 heart container, restores 5 red hearts, and increases speed.

Odd Mushroom (Thin)

120

Fire rate up

Increases Tears and Speed while reducing Damage.

Odd Mushroom (Large)

121

DMG up

Grants an empty heart container. Increases damage, range and shot height while reducing speed.

♥♥♥♥♥ of Babylon

122

Curse up

Increases damage and speed whenever Isaac has half a red heart or less (one red heart for Eve), ignoring any soul or black hearts.

Bobby-Bomb

125

Homing bombs!

Gives Isaac 5 Bombs, and causes all dropped bombs to home towards the closest enemy.

Forever Alone

128

Attack fly

Spawns a blue attack fly that orbits a long distance from Isaac.

Bucket of Lard

129

HP up

Grants two empty heart containers and heals Isaac by half a heart, but decreases speed by 0.2.

Bomb Bag

131

Gives bombs

Isaac is followed by a small bag that drops a Bomb, 1+1 Free, or a Troll Bomb every 3 rooms.

A Lump of Coal

132

My Xmas Present

The more distance tears travel, the more damage they will do.

Guppy’s Tail

134

Cursed?

Increases chance of finding gold chests and normal chests, but reduces chance of finding pickups.

Stigmata

138

DMG + HP up

Increases damage, and adds 1 heart container.

Mom’s Purse

139

More trinket room

Allows Isaac to hold 1 additional trinket.

Bob’s Curse

140

+5 poison bombs

Gives 5 bombs and grants all bombs poison effect.

Pageant Boy

141

Ultimate grand supreme

Spawns several coins around Isaac.

Scapular

142

You have been blessed

Once per room, when Isaac is reduced to his last half red Heart, the aura around his head temporarily vanishes and he is granted one Soul Heart.

Speed Ball

143

Speed + shot speed up

Increases speed by 0.3 and shot speed by 20%.

Bum Friend

144

He’s greedy

A portable beggar who follows Isaac, picks up coins for himself, and occasionally drops a pickup after collecting a coin. Does not spawn collectibles.

Infestation

148

They grow inside

1-3 Blue flies randomly spawn every time Isaac gets hit.

Ipecac

149

Explosive shots

Replaces tears with explosive and poisoning projectiles fired in an arc from the mouth.

Tough Love

150

Tooth shot

Adds a chance to shoot a tooth instead of a tear, which deals greater damage than regular tears.

The Mulligan

151

They grow inside

Tears have a 1/6 chance of spawning allied blue flies when they hit an enemy.

Technology 2

152

Laser

Decreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously.

Mutant Spider

153

Quad shot

Grants quadruple shot but decreases tears.

Chemical Peel

154

DMG up

Tears fired from left eye do increased damage.

The Peeper

155

Plop!

Spawns a familiar that floats slowly around the room on a zig-zag pattern similar to Boom Flies damaging enemies it passes through.

Habit

156

Item Martyr

When Isaac is hit, 1 point of an item’s charge is filled.

Bloody Lust

157

RAGE!

Increases damage as Isaac receives damage. Damage increase stays for the whole floor.

Spirit of the Night

159

Scary

Grants spectral tears and flight.

Ankh

161

Eternal life?

Upon death, the player will respawn as ??? with 3 soul hearts.

Celtic Cross

162

You feel blessed

Grants a chance to trigger the Book of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 7 seconds.

Ghost Baby

163

Spectral buddy

Spawns a familiar that follows Isaac around and fires spectral tears.

Cat-O-Nine-Tails

165

Shot speed + damage up

Increases Shot Speed and damage.

Harlequin Baby

167

Double shot buddy

Spawns a familiar that follows Isaac around and fires two tears at once in a V-pattern.

Epic Fetus

168

On-demand air strike

Isaac’s tears are replaced with guided missiles, like those used by the Doctor’s Remote.

Polyphemus

169

Mega Tears

Makes Isaac shoot one huge tear. Also reduces Tears to minimum. Damage increased . If tear does more damage than an enemy’s life, the tear continues to travel with the extra remaining damage.

Daddy Longlegs

170

Daddy’s love

Daddy Long Legs’ shadow follows Isaac and stomps on enemies.

Sacrificial Dagger

172

My fate protects me

Dagger orbits Isaac, dealing very high damage.

Mitre

173

You Feel Blessed

Grants a chance of converting any red hearts pickups into soul hearts instead.

Rainbow Baby

174

Random buddy

Spawns a familiar that follows Isaac around and fires tears with random effects.

Stem Cells

176

HP up

Adds one filled heart container and increases Shot Speed.

Holy Water

178

Splash!

When Isaac receives damage, the bottle breaks and a puddle of blue creep forms, which damages non-flying enemies, similar to Lemon Mishap. The bottle is reformed upon entering a different room.

Fate

179

Flight eternal

Grants flight and one eternal heart.

The Black Bean

180

Toot on touch

When taking damage, Isaac farts, causing poison damage to all enemies in range.

Sacred Heart

182

Homing shots + DMG up

Increases damage and range while reducing shot speed and grants homing tears. Grants a Heart Container and replenishes all Red Hearts.

Toothpicks

183

Tears + shot speed up

Increases tears and shot speed.

Holy Grail

184

Flight + HP up

Grants flight and one heart container.

Dead Dove

185

Flight + spectral tears

Grants spectral tears and flight.

Guppy’s Hair Ball

187

Swing it

Loosely follows behind Isaac. Can be swung like a flail by rapidly spinning Isaac in a circle. Grows bigger by killing enemies.

Abel

188

Mirrored buddy

A familiar that mirrors the player’s movements and shoots in the opposite direction.

SMB Super Fan

189

All stats up

Increases all stats.

Pyro

190

99 bombs

Adds 99 bombs.

3 Dollar Bill

191

Rainbow tears

Gives Isaac a random tear effect every room. The effect given changes upon entering a room.

The effect changes every 3 seconds.

MEAT!

193

DMG + HP up

Adds a heart container, and increases damage.

Magic 8 Ball

194

Shot speed up

Increases Shot Speed, and drops a Tarot Card when picked up.

Mom’s Coin Purse

195

What’s all this…?

Spawns 4 random pills around Isaac.

Squeezy

196

Tears up

Increases tears by 0.4, and spawns 2 Soul Hearts pickups.

Jesus Juice

197

Damage + range up

Increases Damage and Range.

Box

198

Stuff

Spawns 1 of each (non-collectible) item: 1 coin, 1 key, 1 bomb, 1 heart, 1 card, 1 pill, 1 trinket.

Mom’s Key

199

Less is now more +2 keys

Spawns 2 keys. Generates additional pickups from chests.

Mom’s Eyeshadow

200

Charm tears

Tears have a chance to charm enemies.

Iron Bar

201

Concussive tears

Increases damage by 0.3 and adds a chance to shoot concussive tears, causing enemies to walk around randomly.

Midas’ Touch

202

Golden touch

Enemies that touch you are stunned and turn gold. Any enemy killed while in this state will drop a coin.

Humbling Bundle

203

1+1 free 4evar!

Gives one extra pickup (1+1 Free version) of Red Hearts, pennies, bombs and Keys. Does not work with blue, black and half red hearts, nickels and dimes.

Fanny Pack

204

It’s filled with goodies!

Has a chance to drop a random pickup when Isaac takes damage.

Sharp Plug

205

Charge with blood

Using an activated item while it’s not charged will charge it and Sharp Plug does 2 full heart damage to Isaac.

Guillotine

206

An out-of-body experience

Isaac’s head is removed from his body and floats around him. Increases Damage by 1 and grants -1 Tear Delay.

Ball of Bandages

207

Gotta lick ’em all!

Orbiting familiar that deals damage to enemies. If collected while already having one, makes the familiar evolve. Only drops from Horsemen. Similar to Cube of Meat.

Champion Belt

208

DMG + Challenge Up

Increases damage, but also increases the chance of champion enemies appearing.

Butt Bombs

209

Toxic blast +5 bombs

Gives +5 bombs and makes all bombs Butt Bombs that fill the room with gas, damaging and confusing all enemies.

Gnawed Leaf

210

Unbreakable

After standing still and not shooting for a short time, Isaac turns invincible until he moves or shoots.

Spider Baby

211

Spider revenge

When hit, spawns up to 2 blue spiders.

Guppy’s Collar

212

Eternal Life?

Permanent 50% chance to respawn with 1/2 heart after death.

Lost Contact

213

Shielded tears

Every tear has a small shield which will allow it to block one enemy projectile.

Anemic

214

Toxic blood

+5 range. After Isaac is damaged, a trail of red creep will be left behind Isaac until he leaves the current room.

Goat Head

215

He accepts your offering

A Devil Room / Angel Room Door will always spawn after every boss fight, excluding the first floor and floors after Utero II/Womb II.

Ceremonial Robes

216

Sin up

Adds 3 black hearts and increases Damage by 1.

Mom’s Wig

217

You feel itchy…

Adds a chance to spawn blue spiders when firing tears. Restores 1 red heart.

Placenta

218

HP up + regen

Grants a full heart container, and a chance to regenerate a half-heart of health every minute of gameplay.

Old Bandage

219

HP up

Adds one empty heart container. Whenever Isaac takes damage there’s a chance that a Red Heart may drop.

Sad Bombs

220

Tear blast +5 bombs

+5 Bombs. Upon exploding, bombs shoot 8 tears off in every direction, similar to Tammy’s Head. The tears are affected by any tear modifiers Isaac has on his own tears.

Rubber Cement

221

Bouncing tears

Tears bounce off walls and obstacles (including enemies).

Anti-Gravity

222

Antigravity tears + tears up

-2 Tear Delay. Tears float in position until firing ceases, after which they will fly off in the direction they were shot in.

Pyromaniac

223

It hurts so good +5 Bombs

Isaac heals 1 heart instead of taking damage by a explosive blast from source. Adds 5 bombs.

Cricket’s Body

224

Tears up + splash damage

Grants -1 Tear Delay and reduces Range. When tears hit an object or deplete their range, they spawn 4 smaller tears, whose Range and Damage scale with Isaac’s.

Gimpy

225

Sweet Suffering

Has a chance of spawning a soul heart or black heart when taking damage. Enemies have a chance to drop a Half Red Heart after being killed.

Black Lotus

226

HP up x3!

Grants the player one red heart container, one soul heart, and one black heart.

Piggy Bank

227

My life savings

Gives 3 pennies on pick-up. Every time Isaac is damaged, he will drop one additional penny.

Mom’s Perfume

228

Fear shot

Adds a chance to shoot fear tears and decreases tear delay by 1.

Monstro’s Lung

229

Charged attack

Increases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.

Abaddon

230

Evil + DMG up + fear shot

Increases damage and speed, removes all red heart containers, grants six black hearts, and adds a chance to shoot fear tears.

Ball of Tar

231

Sticky feet…

Adds a chance to shoot slowing tears and the character leaves a trail of slowing creep behind as he moves, impeding enemies’ speed.

Stop Watch

232

Let’s slow this down a bit

Automatically inflicts slow to all enemies in every room.

Upon taking damage, inflicts slow to all enemies for the current room.

Tiny Planet

233

Orbiting tears + range up

Range up and makes shot tears revolve around Isaac until they drop.

Infestation 2

234

Infestation shot

Spawns allied blue spiders from killed enemies.

E Coli

236

Turdy touch

Gives “Turdy Touch” Effect. Enemies that touch Isaac are changed into poop.

Death’s Touch

237

Penetrative shot + damage up

Increases Damage by 1.5, reduces Tears by 0.3 and increases tear size. Grants piercing tears. Tears are replaced by Death’s scythes, which is a cosmetic effect only.

Key Piece 1

238

???

Combined with Key Piece 2, unlocks the golden gate in the starting room of The Chest and Dark Room to fight Mega Satan.

Key Piece 2

239

???

Combined with Key Piece 1, unlocks the golden gate in the starting room of The Chest and Dark Room to fight Mega Satan.

Experimental Treatment

240

All stats up, then shuffled

Randomly increases and decreases some of the character’s stats. There will always be at least one stat increase and one decrease and the same stats can be increased/decreased multiple times.

Contract From Below

241

Wealth… but at what cost?

Doubles the number of pickups and chests spawned after clearing a room or performing some other triggering action (such as using a blood donation machine), but reduces the chance for any pickups to spawn at all.

Infamy

242

Damage Reduction

Chance to block projectiles coming from any direction.

Trinity Shield

243

“You feel guarded”

Isaac gains a shield that protects him from enemy shots.

Tech.5

244

It’s still being tested…

Grants a unlimited range piercing laser with random rate of fire that does not replace tears. The laser might occasionally fire with the effect of a random item or trinket, such as Hook Worm, Spoon Bender or Tiny Planet.

20/20

245

Double shot

Grants double shot.

Blue Map

246

Secrets

Shows secret and super secret room locations on the map.

BFFS!

247

Your Friends Rule!

Increases the size and damage of familiars.

Hive Mind

248

Giant spiders and flies

Increases the size of blue spiders and Blue Flies and doubles the amount of damage they deal.

There’s Options

249

More options

There will be 2 items available to choose from after defeating a boss. Choosing 1 item causes the other to disappear.

Bogo Bombs

250

1+1 boom!

All standard bomb pickups become 1+1 bomb pickups.

Starter Deck

251

Extra card room

Isaac can hold 2 cards at once and all pills are replaced by cards.

Little Baggy

252

Extra pill room

Isaac can hold 2 pills at once and all cards are replaced by pills.

Magic Scab

253

HP + Luck up

Increases luck and HP by 1.

Blood Clot

254

DMG + range up

Increases damage by 1 and range by 5 for tears fired from the left eye.

Screw

255

Tears + shot speed up

Tears and shot speed up.

Hot Bombs

256

Burning blast +5 bombs

Grants 5 bombs. Isaac’s bombs leave behind fire that damages enemies upon contact.

Fire Mind

257

Flaming tears

Grants flaming tears that deal burning damage over time. Tears have a chance to explode on impact with an enemy, which creates a fire at the location of the explosion.

Missing No.

258

Syntax error

Randomizes all passive items upon pickup and at the start of each succeeding floor.

Dark Matter

259

Fear shot

Increases Damage by 1 and adds a chance to shoot fear tears.

Black Candle

260

Curse immunity + evil up

Prevents curses. Grants one black heart. Increases the chance for a Devil or Angel Room to appear.

Proptosis

261

Short range mega tears

Tears start out massive with high damage, and then shrink down and become weaker over a short range.

Missing Page 2

262

Evil up. Your enemies will pay!

Gives 1 black heart. Upon taking damage that reduces Isaac’s health to one heart or less, activates The Necronomicon effect, dealing 40 damage to all enemies in the room.

Smart Fly

264

Revenge fly

After Isaac takes damage, this fly will deal continuous touch damage to whatever enemy caused the damage until it is dead. The fly will then systematically attack 1 enemy at a time until the room is cleared.

Dry Baby

265

Immortal Friend

Spawns a familiar that follows Isaac around and blocks enemy projectiles. Upon blocking a shot it has a chance of triggering The Necronomicon effect.

Juicy Sack

266

Sticky babies

A familiar that follows behind Isaac. It drips a trail of creep, which slows enemies, and spawns 1-2 blue spiders after each room.

Robo-Baby 2.0

267

We worked out all the kinks

Fires lasers at any enemy in its line of sight and moves based on the direction Isaac is firing tears.

Rotten Baby

268

Infested friend

A familiar that spawns blue flies.

Headless Baby

269

Bloody Friend

Familiar that follows Isaac, leaving blood creep on the ground.

Leech

270

Blood sucker

Spawns a friendly familiar leech on the ground that hunts down enemies and heals you for half a heart each time it eats one.

Mystery Sack

271

Spawns a familiar that follows Isaac around and has a chance to drop a heart, coin, bomb, or key after clearing a room.

BBF

272

Big Beautiful Fly

Spawns a familiar that flies around the room in a manner similar to the Boom Fly and explodes on contact with an enemy. Respawns after ten seconds.

Bob’s Brain

273

Explosive thoughts

Spawns a familiar that charges forward when shooting tears, explodes upon contact with an enemy and poisons them. Respawns after few seconds.

Best Bud

274

Sworn protector

When hit, summons a white attack fly similar to Distant Admiration for the current room.

Lil Brimstone

275

Evil Friend

A Familiar that shoots a small Brimstone beam. Must charge like the Brimstone Item before shooting.

Isaac’s Heart

276

Protect It

Isaac himself is now immune to all damage, and a heart familiar appears and follows Isaac. If the heart is hurt, Isaac is hurt.

Lil Haunt

277

Fear him

A familiar that damages enemies by chasing them as well as inducing the fear effect.

Dark Bum

278

He wants to take your life

Spawns a familiar that follows Isaac around and collects red hearts. For every one-and-a-half red hearts collected, Dark Bum will generate one soul heart, one hostile Spider or one friendly blue spider.

Big Fan

279

Fat protector

Spawns a large orbital familiar that blocks enemy projectiles and deals slight contact damage to enemies.

Sissy Longlegs

280

She loves you

Wanders about the room, occasionally spawning blue spiders.

Punching Bag

281

Scape Goat

Spawns a Mulligan Familiar that will wander the room randomly. Enemies will attack the Mulligan if it’s closer.

Taurus

299

Speed down + rage is building

Speed down, gains speed while in a room with enemies until gaining My Little Unicorn effect for a few seconds.

Aries

300

Ramming speed

+0.25 Speed. Running into enemies while at a high speed will deal 18 points of damage. Does not prevent contact damage.

Cancer

301

HP up + you feel protected

Adds 3 soul hearts. Grants The Wafer effect for the current room upon taking damage.

Leo

302

Stompy

Allows you to crush rocks when you walk over them.

Virgo

303

You feel refreshed and protected

Grants a chance to trigger the Book of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 10 seconds. Also converts “bad pills” into “good pills”.

Libra

304

You Feel Balanced

Gives 6 coins, 6 bombs and 6 keys and balances out all attributes.

Scorpio

305

Poison tears

Grants poison tears, which deal damage over time when inflicted.

Sagittarius

306

Penetrative shot + speed up

Increases speed by +0.2 and grants piercing tears.

Capricorn

307

All stats up

All stats up.

Aquarius

308

Trail of tears

A trail of blue creep is left behind Isaac, which damages enemies.

Pisces

309

Tears up + knock-back shots

-1 Tear Delay, adds knock-back shots and increases tear size.

Eve’s Mascara

310

Shot speed down + DMG up

Doubles damage, halves tears stat, and greatly reduces shot speed.

Judas’ Shadow

311

Sweet revenge

Adds an extra life; upon death, it respawns Isaac as Black Judas with only two black hearts.

Maggy’s Bow

312

HP up + you feel healthy

Gives one heart container and doubles the healing provided by red hearts.

Holy Mantle

313

Holy shield

Automatically negates first taken damage in every room.

Thunder Thighs

314

HP up + speed down + you feel stompy

Destroys rocks upon contact with Isaac. Adds one heart container, and lowers Speed.

Strange Attractor

315

Magnetic tears

Pickups, trinkets and monsters are magnetically attracted to Isaac’s tears.

Cursed Eye

316

Cursed charge shot

Grants charged tears that can be fired in a tight burst of four. Getting hit while charging will teleport Isaac into another room.

Mysterious Liquid

317

Toxic Splash Damage

Tears leave a small, short lasting pool of creep on impact or when their range is depleted.

Gemini

318

Conjoined friend

Suture becomes attached to Isaac, and does touch damage to enemies within its attacking range.

Cain’s Other Eye

319

Near sighted friend

Spawns a familiar that floats slowly around the room on a zig-zag pattern similar to The Peeper and shoots normal tears in the same direction as Isaac.

???’s Only Friend

320

Controlled friend

Summons a big attack fly that can be controlled with the shooting direction-keys.

Samson’s Chains

321

The ol’ ball and chain

Pull a chain and ball behind you that will damage enemies on contact and is able to break stones.

Mongo Baby

322

Mongo Friend

Summons a familiar that copies the tears of Isaac’s other familiars.

The Polaroid

327

Fate Chosen

If the character has half a red heart or no red hearts after taking damage, it triggers the Book Of Shadows effect, creating a shield that nullifies all types of damage for 5 seconds. Also allows entrance into The Chest.

The Negative

328

Fate Chosen

If the character has half a red heart or no red hearts after taking damage, it triggers The Necronomicon effect, damaging all enemies in the room. Also allows entrance into the Dark Room.

The Ludovico Technique

329

Controlled Tears

Instead of firing tears, Isaac controls one floating tear that hover over obstacles. This tear deals constant damage when held in place over an enemy.

Soy Milk

330

DMG Down + Tears Way Up

Tears shrink and do much less damage, but fire in very rapid succession.

Godhead

331

God tears

Increases damage and range while reducing tears and shot speed. Grants homing tears and tears gain a damaging halo.

Lazarus’ Rags

332

Eternal Life?

Upon dying, resurrect as Revived Lazarus with one heart container and Anemic item.

The Mind

333

I know all

Grants the combined effects of the Blue Map, Treasure Map and The Compass, revealing the floor layout and all special rooms, including Secret Rooms and Super Secret Rooms.

The Body

334

I feel all

Adds 3 heart containers.

The Soul

335

I am all

Grants two soul hearts. Isaac now repels enemy projectiles.

Dead Onion

336

Toxic aura tears

Grants piercing and spectral tears. Increases tear size (without increasing damage) while greatly reducing range and shot speed.

Broken Watch

337

I think it’s broken

Chance upon entering a room to slow down or speed up every enemy and their attacks. The chance to slow enemies is quite higher than the chance to speed them up.

Safety Pin

339

Evil + range + shot speed up

Increases range and shot speed, while adding 1 Black Heart.

Caffeine Pill

340

Speed up + size down

Increases speed and reduces character size. Also gives a random pill.

Torn Photo

341

Tears + shot speed up

Tears + Shot speed up.

Blue Cap

342

HP + tears up + shot speed down

Grants 1 heart container and increases tears, but decreases shot speed.

Latch Key

343

Luck up

Increases Luck by 1, grants 1 Soul Heart and spawns 2 Keys.

Match Book

344

Evil up

Grants Isaac 1 Black Heart and 3 bombs. Can also give troll bombs.

Synthoil

345

DMG up + range

Increases damage by 1, range by 5.25, and tear height by 0.5.

A Snack

346

HP up

Adds 1 heart container.

Toxic Shock

350

Mass poison

Upon entering a room, poisons all enemies, dealing double Isaac’s tear damage. Killing enemies leaves a small, short lasting pool of green creep on the ground.

Bomber Boy

353

Explosive blast!

+5 bombs. Isaac’s bombs will now explode in a large cross-shaped pattern (roughly 5 bombs explosions wide). This also affects troll bombs.

Crack Jacks

354

Don’t swallow the prize!

Adds one heart container and drops a random trinket.

Mom’s Pearls

355

Range + luck up

+1.25 Range Up. +0.5 Tear Height. +1 Luck Up.

Car Battery

356

Double charge!

Causes Isaac’s activated item to activate twice on each use.

The Wiz

358

Double wiz shot!

Tears simultaneously fire out of both eyes diagonally, similar to the effect of the R U A Wizard? pill. Isaac’s tears also travel above all obstacles.

8 Inch Nails

359

Stick it to ’em!

+1.5 Damage Up. Replaces Isaac’s tears with nails, which have increased knockback.

Incubus

360

Dark friend

A demonic familiar that follows Isaac and shoots tears identical to Isaac’s in terms of damage, range, fire rate, and effects.

Fate’s Reward

361

Your fate beside you

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

Lil Chest

362

What’s in the box?

Spawns a chest familiar that follows Isaac and drops a random pickup every few rooms.

Sworn Protector

363

Protective friend

An orbital angel which does 7 contact damage per tick and blocks enemy shots. When it blocks a shot, it has a very small chance to drop an eternal heart.

Friend Zone

364

Friendly fly

A white orbiting fly which deals 3 contact damage per tick to enemies. This familiar orbits Isaac at a middle length distance somewhere between Distant Admiration and Forever Alone.

Lost Fly

365

Lost protector

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

Scatter Bombs

366

‘We put bombs in your bombs!’

Adds 5 bombs. Isaac’s bombs explode into 2-4 tiny bombs

Sticky Bombs

367

Egg sack bombs!

+5 bombs. Bombs stick to enemies and spawn 2-4 blue spiders if they kill an enemy.

Epiphora

368

Intensifying tears

Shooting in one direction increases Isaac’s rate of fire until the cap is reached. As soon as Isaac changes direction or stops shooting, rate of fire is reset to its normal amount.

Continuum

369

Transcendent tears

+2.25 Range Up. +1.5 Tear Height. Isaac’s tears travel through walls and appear out of the opposite wall. Isaac’s tears also travel over rocks and objects.

Mr. Dolly

370

Range + tears up

Tears and Range up. Spawns 3 random types of hearts on the floor when picked up.

Curse of the Tower

371

You feel cursed…

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

Charged Baby

372

Bbbzzzzzt!

A familiar baby that drops a battery every 4 rooms. Has a small chance to freeze all enemies in the room when hit.

Dead Eye

373

Accuracy brings power!

Isaac’s damage increases each time an enemy is hit. Damage is reset upon missing a shot.

Holy Light

374

Holy shot!

Isaac has a random chance to fire a Holy tear, which when it hits an enemy, will spawn a Crack the Sky style light beam on the same enemy, dealing damage.

Host Hat

375

Nice hat!

A host familiar that sits on Isaac’s head and has a random chance to block enemy shots and retaliate with 3 tears. Grants immunity to explosions.

Restock

376

Never ending stores!

Causes shops to instantly restock their items when they are bought. Granted by default for every character in Greed Mode.

Bursting Sack

377

Spider love

Spider enemies no longer target or deal contact damage to Isaac.

No. 2

378

Uh oh…

Continuously firing tears for several seconds causes Isaac to drop a Butt Bomb. 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.

Pupula Duplex

379

Wide shot

Transforms Isaac’s tears into a wide arc shape which gives them a much larger hitbox. Gives Isaac spectral tears which allows them to travel through objects in the environment (i.e. rocks).

Pay to Play

380

Money talks

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.

Eden’s Blessing

381

Your future shines brighter

Tears up. Grants a random item at the start of the next run.

Lil Gurdy

384

A gurd of your own!

Gives Isaac a Gurdy familiar that will charge around the room dealing contact damage to enemies. Lil Gurdy is charged by holding down a fire button and letting go. The longer the button is held, the faster Lil Gurdy will fling itself across the screen. Lil Gurdy can pass over objects and obstacles in the room.

Bumbo

385

Bumbo want coin!

Spawns a beggar familiar which floats around the room and picks up any nearby coins, leveling up after collecting several coins. At level 2, Bumbo gains a body. At level 3, it begins to fire tears. At level 4, Bumbo chases enemies slowly, dealing contact damage.

Censer

387

Peace be with you

Gives Isaac a golden censer familiar which creates a huge aura of light that slows down any enemies and enemy shots inside it.

Key Bum

388

He wants your keys!

Spawns a portable key master that follows Isaac and collects keys, giving random chests in return.

Rune Bag

389

Rune generator

A bag that follows Isaac and drops a random mystic rune every 3 rooms.

Seraphim

390

Sworn friend

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

Betrayal

391

Turn your enemy

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

Zodiac

392

The heavens will change you

Zodiac will give Isaac a random zodiac item effect that changes after every floor.

Serpent’s Kiss

393

The kiss of death

Tears now have a random chance to apply a poison effect, causing 4 or 6 damage per tick to enemies (Similar to The Common Cold item). 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 chance to drop a black heart when killed.

Marked

394

Directed tears

Isaac will now fire tears automatically directed at a red target on the ground which is controlled by the player. This allows for a full 360 degree tear firing radius. Can be overridden by other tear modifiers such as Mom’s Knife or Brimstone.

Tech X

395

Laser ring tears

Tears are replaced with laser rings that pierce through enemies and deal damage to enemies within them. Can be charged to increase the size of the ring.

Tractor Beam

397

Control your tears

Isaac emits a beam from his face. Isaac’s tears travel in the path of the beam.

God’s Flesh

398

Shrink shot

Tears now have a random chance to apply a shrinking effect, causing enemies to shrink in size and also run away from Isaac. Shrunk enemies can be crushed and killed by walking over them

Maw of the Void

399

Consume thy enemy!

+1.0 Damage Up. After continuously firing tears for 2.5 seconds, a red cross appears on Isaac’s head that, upon releasing the fire button, creates a black ring that rapidly deals damage equal to Isaac’s tear damage to any enemies in contact with it.

Spear of Destiny

400

Your destiny

In addition to tears, Isaac now holds a spear in front of him which deals damage equal to 2 times his tear damage, and occasionally inflicts fear. The spear cannot be thrown, but deals damage while it is in contact with an enemy.

Explosivo

401

Sticky bomb shot!

Isaac’s tears have a chance to stick to enemies and explode.

Chaos

402

!!!

Chaos causes items to be chosen from random item pools. When picked up, drops between 1-6 random pickups on the floor.

Spider Mod

403

Mod buddy!

Displays Isaac’s tear damage and enemy health bars. Spawns a gray spider familiar that wanders around and inflicts a random status effect on any enemies it comes into contact with. Occasionally spawns a blue spider upon clearing a room.

Farting Baby

404

It farts!

A familiar that follows Isaac and blocks tears. If a tear hits Farting Baby, there is a high chance for it to fart, which will either knock back, poison, or charm all nearby enemies.

GB Bug

405

Game breaking bug, right away!

A glitch familiar that bounces around the room and applies a random status effect to any enemies it comes into contact with and has a chance to re-roll pickups that it passes over.

Purity

407

Aura stat boost

This item will boost one of Isaac’s stats depending on the color of the aura around him. The aura will disappear upon taking damage and will reappear with a random color upon entering a new room. A red aura boosts damage, a blue aura boosts rate of fire, a yellow aura boosts speed, and an orange aura boosts range.

Athame

408

Call to the void

Whenever Isaac takes damage, a black ring briefly appears around Isaac, dealing damage to all nearby enemies.

Empty Vessel

409

I reward an empty vessel

While Isaac has no red hearts, this item grants flight and a random chance to activate an invincibility shield for a few seconds. If Isaac gains any red hearts, these benefits will disappear.

Evil Eye

410

Eye shot!

While firing tears, Isaac has a chance to fire an eye across the screen with a very slow shot speed, which will fire tears of its own in the same direction as Isaac. The eye will be destroyed if it comes into contact with an enemy or obstacle

Lusty Blood

411

Their blood brings rage!

Each time Isaac kills an enemy, Isaac’s damage increases for the current room.

Cambion Conception

412

Feed them hate

After taking damage a certain amount of times, a permanent demonic familiar spawns.

Immaculate Conception

413

Feed them love

Upon picking up a certain amount of health, spawn a permanent angelic familiar.

More Options

414

There are even more options!

Two items spawn in every Treasure Room. Only one can be taken; the other will disappear.

Crown of Light

415

The untainted gain power

Gives Isaac a crown that glows blue when active, and turns gray when inactive. While Isaac has no empty red heart containers, Isaac’s tears are replaced with blue diamond tears that deal double damage. Regardless of health, the crown will deactivate for the current room when Isaac takes damage.

Deep Pockets

416

More stuff to carry!

Allows Isaac to carry two cards or pills (or a combination of both) at the same time.

Succubus

417

Damage booster

Spawns a flying familiar that bounces around the room with a black aura, dealing rapid damage to any enemies inside it. While standing in the aura, Isaac gains a 1.5x tear damage multiplier.

Fruit Cake

418

Rainbow Effects!

Isaac’s tears gain a random effect that changes every shot.

Black Powder

420

Spin the black circle!

Isaac leaves a trail of black powder on the floor. Walking in a circle will spawn a pentagram symbol on the floor, which deals 10 damage per tick to any enemies inside it.

Circle of Protection

423

Protect me from myself

Surrounds Isaac with a large white halo around him that pulsates. With each pulse, the halo deals contact damage to enemies equal to Isaac’s damage. Each pulse also converts any enemy shots touching the ring into friendly purple homing tears.

Sack Head

424

More sacks!

Greatly increases the chance to find sacks.

Night Light

425

Scared of the dark?

A cone of light shines in the direction Isaac is moving that slows enemies and enemy shots.

Obsessed Fan

426

Follows my every move…

A purple fly familiar that follows Isaac’s movements on a 3 second delay and deals contact damage to enemies.

PJs

428

You feel cozy

Adds 4 Soul Hearts and fully restores Isaac’s red health.

Head of the Keeper

429

Penny tears!

Isaac’s tears become coins and now have a chance to drop pennies on the floor upon successfully hitting an enemy.

Papa Fly

430

Turret follower

A blue fly familiar follows Isaac’s movements on a 3 second delay. Papa Fly will fire tears at nearby enemies.

Multidimensional Baby

431

ydduB Buddy

Spawns a familiar that will follow Isaac’s movements on a 2.5 second delay. Tears that pass through the baby will be doubled and increase in speed.

Glitter Bombs

432

Prize Bombs!

Gives Isaac 5 bombs, and makes Isaac’s bombs have a chance to drop random pickups or charm enemies when they explode.

My Shadow

433

Me! And my shaaaadow!

Each time Isaac takes damage, inflicts fear on all enemies in the room and spawns a black Charger familiar that will attack enemies. The Charger will be killed if it is damaged too much.

Lil’ Loki

435

4-way buddy!

A Loki familiar that follows Isaac and shoots 4 tears in a cross pattern.

Milk!

436

Don’t cry over it…

A glass of milk follows Isaac and spills on the floor upon taking damage. After the milk spills, Isaac’s tear delay is decreased by 2 for the rest of the room.

Binky

438

Memories…

Tears up, adds 1 soul heart, and decreases Isaac’s size.

Kidney Stone

440

Matt’s kidney stone

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

Dark Prince’s Crown

442

Loss is power

Increases range, tears, and shot speed when at exactly one red heart.

Apple!

443

Trick or treat?

Increases tears. Adds a chance to fire a high-damage razor blade.

Lead Pencil

444

He’s a bleeder!

After every 15 tears fired, Isaac will fire a high-damage cluster of tears.

Dog Tooth

445

Bark at the moon!

Increases damage and speed. Upon entering a room adjacent to a secret room, a howl sound effect will play.

Dead Tooth

446

Halitosis

While firing, Isaac gains a green aura that poisons nearby enemies.

Linger Bean

447

Crying makes me toot

Adds a chance to fire a gas cloud that damages nearby enemies.

Shard of Glass

448

Blood and guts!

Upon taking damage, Isaac has a chance to drop a full red heart, gain 5 range, and leave a trail of damaging red creep for the current room.

Metal Plate

449

It itches…

Adds a chance to reflect enemy shots. Grants one soul heart.

Eye of Greed

450

Gold tears!

Adds a chance to fire tears that temporarily stun enemies and turn them into gold. Any enemy killed while in this state will drop coins.

Tarot Cloth

451

I see the future

Drops a random card or rune. Doubles the effects of cards and runes.

Varicose Veins

452

I’m leaking…

Taking damage releases a ring of 10 high damage tears.

Compound Fracture

453

Bone tears!

Increases range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle.

Polydactyly

454

Hold me!

Allows Isaac to carry two cards, pills, or any combination of both at the same time. Drops a random card or pill.

Dad’s Lost Coin

455

I remember this…

Increases range by 1.5. Drops a lucky penny. Other Effects Unknown

Moldy Bread

456

Midnight snack!

Grants a heart container.

Cone Head

457

Hard headed!

Grants a soul heart. Adds a chance to block enemy shots.

Belly Button

458

What’s in there?

Drops a random trinket. Grants an extra trinket slot.

Sinus Infection

459

Booger tears!

Adds a chance to fire a booger which sticks to enemies and poisons them.

Glaucoma

460

Blind tears!

Adds a chance to shoot concussive tears, causing enemies to walk around randomly.

Parasitoid

461

Egg tears!

Adds a chance to fire an egg sack which spawns slowing creep and spawns a blue fly or spider upon hitting an enemy.

Eye of Belial

462

Possessed tears!

Grants piercing tears. After piercing one enemy, tears start homing and deal double damage.

Sulfuric Acid

463

Acid tears!

Increases damage. Adds a chance to fire acidic tears which can destroy obstacles.

Glyph of Balance

464

A gift from above

Grants 2 soul hearts and modifies drops from Champion Monsters based on certain conditions.

Analog Stick

465

360 tears!

Tears up. Allows Isaac to fire tears diagonally.

Contagion

466

Outbreak!

The first enemy killed in a room explodes and poisons nearby enemies. Poisoned enemies will also explode upon death.

Finger!

467

Watch where you point that!

Spawns a finger familiar that points at enemies, dealing constant damage.

Shade

468

It follows

Spawns a shadow familiar that follows Isaac’s movements on a 1 second delay and deals contact damage to enemies.

Depression

469

🙁

Spawns a cloud familiar that leaves a trail of tears that damages enemies. Has a chance to spawn damaging beams of light onto enemies that touch the cloud.

Hushy

470

Lil hush!

Spawns a Hush familiar that bounces around the room and deals contact damage. While firing tears, it stops moving.

Lil Monstro

471

Ain’t he cute?

Spawns a familiar that fires clusters of tears. Must be charged before shooting.

King Baby

472

Lord of the dead!

Spawns a familiar that follows Isaac and makes other familiars follow it. While firing tears, it stops moving.

Big Chubby

473

Chub chub

Spawns a familiar that slowly charges forward and damages enemies in its path.

Acid Baby

491

Pills pills pills!

Spawns a familiar that drops random pills every 2 rooms cleared. Upon using a pill, all enemies in the room are poisoned.

YO LISTEN!

492

Yo listen!

Increases luck. Spawns a fairy familiar that points out secret room entrances and tinted rocks.

Adrenaline

493

Panic – power

Increases damage based on how many empty heart containers Isaac has.

Jacob’s Ladder

494

Electric tears

Tears fire sparks of electricity in random directions upon hitting an obstacle or enemy.

Ghost Pepper

495

Flame tears

Adds a chance to shoot a fire that damages enemies and remains in place until it deals enough damage or the room is left.

Euthanasia

496

Needle shot

Adds a chance to fire needles. If a needle kills an enemy, it bursts into more needles.

Camo Undies

497

Camo kid

Isaac becomes camouflaged at the beginning of each room. Enemies will not attack Isaac until he starts firing tears.

Duality

498

You feel very balanced

Whenever a Devil or Angel Room would spawn after defeating a boss, both rooms spawn. Only one can be entered.

Eucharist

499

Peace be with you

An Angel Room door will always spawn after every boss fight, excluding the first floor and floors after Utero II/Womb II.

Sack of Sacks

500

Gives Sacks!

Spawns a sack familiar that has a chance to drop a sack upon clearing a room.

Greed’s Gullet

501

Money = Health!

Grants a heart container for every 25 coins Isaac has.

Large Zit

502

Creep shots

Adds a chance to fire a creep shot that deals double damage and leaves a trail of slowing white creep.

Little Horn

503

Science!

Adds a chance to fire a piercing tear that instantly kills any enemy that it touches.

Poke Go

505

Gotta catch em…

Upon entering a room with enemies in it, has a chance to spawn a random charmed enemy that persists across rooms.

Backstabber

506

Watch your back!

Has a chance to fire tears that inflict bleeding on enemies, causing them to slowly take damage over time.

Mom’s Razor

508

It’s sharp!

Spawns an orbiting razor that damages enemies it touches and inflicts bleeding on enemies, causing them to slowly take damage over time.

Bloodshot Eye

509

Bloody friend

Spawns an orbiting eye familiar that fires tears every 2 seconds.

Angry Fly

511

He’s violent

Spawns a fly familiar that orbits around a random enemy and deals 2 damage per tick to enemies it comes in contact with.

Bozo

513

Party time!

Increases damage by a flat 0.1 and grants a soul heart. Enemies can randomly become briefly charmed or feared. Taking damage has a chance to spawn a rainbow poop.

Broken Modem

514

LAG!

Enemies, enemy shots, tears, and pickups will briefly freeze in place at random intervals.

Fast Bombs

517

Faster bomb drops!

Grants 7 bombs and allows bombs to be placed rapidly.

Buddy in a Box

518

What could it be?!

Grants a familiar with a random tear effect. The familiar is randomized at the start of each floor.

Lil Delirium

519

He’s delirious

Grants a familiar that transforms into another random familiar every 10 seconds.

Jumper Cables

520

Bloody Recharge!

Grants an active item charge every 15 enemies killed.

Technology Zero

524

Static tears!

Connects Isaac’s tears with electricity that can damage enemies.

Leprosy

525

You’re tearing me apart!

Upon taking damage, grants a body part as an orbital, which blocks enemy shots and deals 7 damage per tick to enemies it comes in contact with. The orbitals will be destroyed if they take enough damage from enemies or enemy shots.

7 Seals

526

Lil Harbingers!

Grants a random Harbinger familiar that changes every 10 seconds.

Angelic Prism

528

Eclipsed by the moon

Grants a prism orbital with a large orbital radius. Tears that pass through the prism split into four multi-colored tears.

Pop!

529

Eyeball tears!

Replaces Isaac’s tears with eyeballs that can bounce off of each other. The eyeballs are not limited by range, and will instead dissipate when they stop moving or when hitting an enemy or obstacle.

Death’s List

530

Just hope you’re not next…

Grants a reward if all enemies in a room are killed in the order they are marked.

Haemolacria

531

I’m seeing red…

Tears are now fired in an arc. Upon hitting the floor, an obstacle, or an enemy, they burst into many smaller tears in all directions. Increases tear delay.

Lachryphagy

532

Feed them!

Isaac’s tears decelerate as they travel. Upon stopping or hitting an obstacle, they burst into 8 tears in all directions. Tears can be fired into other tears to feed them, increasing their damage.

Trisagion

533

Smite thy enemy

Tears are replaced with piercing white blasts of light.

Schoolbag

534

Extra active item room

Allows Isaac to hold two active items.

All Trinkets

Name

Icon

Quote

Description

Swallowed Penny

Gulp!

Upon taking damage, Isaac drops a penny.

Petrified Poop

It feels lucky?

Greatly increases the chances of a pickup dropping when destroying poop.

AAA Battery

Trickle charge

Automatically recharges the last energy slot of an activated item, effectively reducing recharge rates by one.

Broken Remote

It’s broken

Triggers the Teleport effect whenever an activated item is used.

Purple Heart

Challenge up

Increases chance for challenge rooms to be boss challenge rooms / Causes more enemy champions to spawn.

Broken Magnet

‘It kinda works!’

Pulls coins towards Isaac, but ignores other pickups.

Rosary Bead

Faith up

Increases the chance of Angel Rooms and Eternal Hearts appearing.

Cartridge

I remember these

Chance to trigger The Gamekid effect upon taking damage.

Pulse Worm

Wub wub!

Shots pulse in size.

Wiggle Worm

Wiggle waggle!

Gives Isaac’s shots a wave-like trajectory.

Ring Worm

Woop woop

Gives Isaac spinning shots.

Flat Worm

Blub blub!

Isaac’s tears take on an oblong appearance. They also push enemies back.

Store Credit

YES!

The next store purchase is free. The trinket disappears on purchase.

Callus

Your feet feel stronger

Prevents damage from creep and spikes.

Lucky Rock

There’s something inside it

Each obstacle destroyed drops one coin.

Mom’s Toenail

???

Mom’s foot randomly stomps down somewhere in the room. 1 minute intervals.

Black Lipstick

Evil Up

Increases the chance of Black Hearts appearing.

Bible Tract

Faith up

Increases chance for Eternal Hearts to spawn.

Paper Clip

Master of lockpicking

Golden Chests can be opened without using a key.

Monkey Paw

Wish granted

If the character has half a heart after taking damage, it drops a Black Heart. The effect can trigger up to three times, after which the trinket will disappear.

Mysterious Paper

???

Has a chance to replicate the effects of A Missing Page, The Polaroid, The Negative, or Missing Poster.

Daemon’s Tail

Evil up

Most non-specific heart drops become black hearts, but heart drops are significantly less common.

Missing Poster

???

If Isaac dies in a Sacrifice Room, a puzzle piece will appear on his last will (

and unlocks The Lost).

Revives Isaac as The Lost if unlocked. The Missing Poster then disappears.

Butt Penny

Wealth of gas

Isaac will fart when he picks up a coin.

Mysterious Candy

Uh-oh!

Isaac farts or poops at random intervals. Getting hit can also trigger the effect.

Hook Worm

Zip zoop!

Tears move shifting left to right forming a path of right angles. +10 to Range (effective range remains about the same).

Whip Worm

Wooosh!

Increases shot speed by 0.5, increasing effective range.

Broken Ankh

Eternal life?

When held, Isaac has a chance to be revived as ???. Can occur multiple times in the same run.

Fish Head

It stinks

Spawns a blue fly every time Isaac takes damage.

Pinky Eye

Poison shots

Adds a 10% chance to shoot a poison tear, dealing damage over time when inflicted.

Push Pin

Piercing shots

Adds a 10% chance to shoot a piercing and spectral tear.

Liberty Cap

Touch Fuzzy Get Dizzy

Grants a chance of triggering Mini Mush, Odd Mushroom (Large), Odd Mushroom (Thin) or The Compass effects for the current room upon entering it.

Umbilical Cord

Fetal Protection

When Isaac’s health is brought to half a red heart and no soul hearts, a Little Steven familiar spawns for the current room.

Child’s Heart

It calls out to its brothers.

Increases the chance of a Heart dropping after clearing a room, and the chance of finding a Heart when opening a Chest.

Curved Horn

DMG up

Increases damage by 2.

Rusted Key

It feels lucky?

Improves the chances of finding keys and golden chests.

Goat Hoof

Speed up

Increases speed by 0.15.

Mom’s Pearl

It emanates purity

Grants a secondary 10% chance of any non-specific Heart drop turning into a Soul Heart.

Cancer

Yay, cancer!

-2 Tear Delay (effectively increases firerate of tears).

Red Patch

Your rage grows

Grants a chance of increasing damage by 1.8 for the current room upon taking damage.

Match Stick

Tastes like burning

Increases the chance of Bombs dropping after clearing a room, and the chance of finding Bombs when opening a Chest.

Lucky Toe

Luck up!

Increases Luck by 1.

Cursed Skull

Cursed?

If Isaac has less than one full red heart after taking damage, he will be immediately teleported to the last cleared room he was in.

Safety Cap

Don’t swallow it

Improves the chance of Pills dropping after clearing a room, and chance of finding a Pill when opening a Chest.

Ace of Spades

Luck of the draw

Increases the chance of tarot cards or playing cards dropping after clearing a room, and the chance of finding cards when opening a chest.

Isaac’s Fork

‘Consume Thy Enemy’

A chance to heal Isaac for 1/2 a red heart upon clearing a room.

A Missing Page

It glows with power

5% chance to induce The Necronomicon’s effect upon taking damage.

Bloody Penny

Wealth of health

Gives a 50% chance to drop a half heart when money is collected.

Burnt Penny

Wealth of chaos

Gives a 50% chance to drop a bomb when money is collected.

Flat Penny

Wealth of answers

Gives a 50% chance of spawning a key upon collecting a penny.

Counterfeit Penny

Wealth of wealth

Gives a 50% chance of increasing the value of every coin pickup by one.

Tick

Well, that’s not coming off

Drain 15% health of each enemy with more than 60 HP (ie. most bosses). Also restores one red heart of Isaac whenever he enters an uncleared boss room. The Tick cannot be swapped out for another trinket.

Isaac’s Head

Dead friend

Gives the player Isaac’s severed head as a tear-firing familiar. Fires piercing tears.

Maggy’s Faith

Faith’s reward

Gives an eternal heart at the start of every floor.

Judas’ Tongue

Payment Received

Items in the Devil Room only cost 1 heart. Soul heart trades still cost 3 Soul hearts.

???’s Soul

Imaginary Friend

Spawns a familiar that floats slowly around the room on a pattern similar to The Peeper and fires spectral and homing tears.

Samson’s Lock

Your rage grows

1/15 chance to increase damage by 0.5 for the current room each time an enemy dies.

Cain’s Eye

May you see your destination

When starting a floor, 25% chance to get the The Compass effect for the duration of a floor.

Eve’s Bird Foot

Revenge from beyond

5% chance to spawn a Dead Bird familiar for the current room each time an enemy dies.

The Left Hand

The left-hand path reaps dark rewards

Replaces brown chests and golden chests with red chests.

Shiny Rock

It shines for its brothers

Tinted rocks and rocks with Crawl Spaces will flash white every 10 seconds.

Safety Scissors

Fuse Cutter

Troll bombs turn into Bomb pickups before they explode. Mega troll bombs turn into 1+1 free bombs before they explode.

Rainbow Worm

Bleep Bloop Blop

Isaac’s tears gain a random worm effect that changes every 3 seconds.

Tape Worm

Floooooooooop!

Doubles Isaac’s range and halves his tear height.

Lazy Worm

Pft

Tear shot speed is greatly reduced.

Cracked Dice

You feel cursed… kinda.

Whenever Isaac gets hit, there is a chance that the effect of The D6, D8, D12, or D20 gets activated.

Super Magnet

It Pulls

Pulls enemies and pickups towards Isaac.

Faded Polaroid

You feel faded

Occasionally causes Isaac to blend into the ground, which briefly confuses all enemies in the room.

Louse

Itchy, tasty…

Occasionally spawns a Blue Spider.

Bob’s Bladder

Creepy bombs

Leaves a pool of green creep under all bombs Isaac places, which damages enemies that walk over it.

Watch Battery

Lil charge

Increased chance of batteries spawning. Has a chance to add an extra charge to Isaac’s activated item upon completing a room.

Blasting Cap

Pop! Pop!

Exploding bombs have a chance to drop another bomb pickup.

Stud Finder

The ground below feels hollow…

Increases the chance to find a Crawl Space.

Error

Effect not found?

Gives a random trinket effect each room.

Poker Chip

It’s double down time!

Chests have a 50% chance of paying out with extra pickups and a 50% chance of paying out with nothing or enemies.

Blister

Bounce back!

Increases knockback of tears.

Second Hand

Extended stat effect time!

Increases the time that status effects stay on enemies.

Endless Nameless

I’m stuck in a loop…

When Isaac uses a pill, card, or rune, there is a chance to spawn another one of the same type.

Black Feather

With darkness comes power

Increases Isaac’s damage for possessing certain evil items.

Blind Rage

Blind to damage

Increases invincibility time after getting hit.

Golden Horse Shoe

Feel lucky?

+15% chance for a Treasure Room with two items to spawn.

Store Key

Stores are open

Automatically opens all Shops.

Rib of Greed

Feels greedy

Prevents Greed and Super Greed from appearing in Shops and Secret Rooms.

Karma

Karma up

Donating to a Donation Machine has a chance to heal Isaac for a full red heart or spawn a Beggar. Increases the chance that donating to a Donation Machine will increase Isaac’s luck.

Lil Larva

The poop is moving…

Spawns a blue fly from every pile of poop Isaac destroys.

Mom’s Locket

You feel her love

Grants half a red heart each time a key is used. Converts half red heart pickups into full red hearts.

NO!

Never again!

Removes all active items from every item pool.

Child Leash

Keep your friends close…

Causes familiars to stay closer to each other.

Brown Cap

Fartoom!

Poop will explode after being destroyed.

Meconium

Eww

Poop has a chance to turn into black poop.

Cracked Crown

Boost stats

Grants extra stat upgrades based on Isaac’s passive items that increase stats. Also grants tears up and -1 tear delay.

Used Diaper

You stink

Grants the Skatole effect in some rooms.

Fish Tail

It also stinks!

Items and trinkets that generate blue flies or blue spiders will generate twice as many.

Black Tooth

It looks dead

Adds a chance to fire a black tooth that poisons enemies.

Ouroboros Worm

Foop foop!

Tears travel in a large spiral pattern and become spectral.

Tonsil

Sick…

When hit, there is a small chance a removed tonsil familiar starts following Isaac, blocking enemy shots.

Nose Goblin

Seems magic…

Chance to fire a booger that sticks to enemies and deals damage over time.

Super Ball

Boing!

Makes tears have a chance to bounce off enemies and obstacles.

Vibrant Bulb

100

It needs power

Provides a boost to all stats when Isaac’s active item is fully charged.

Dim Bulb

101

I think it’s broken

Provides a boost to all stats when Isaac’s active item is completely uncharged.

Fragmented Card

102

Double moon

Makes two Secret Rooms spawn on each floor.

Equality!

103

Turns pickups into their doubled versions while Isaac’s numbers of coins, bombs and keys are equal.

Wish Bone

104

Make a wish

Taking damage has a small chance to destroy the trinket and spawn a random item.

Bag Lunch

105

I wonder what it is

Taking damage has a small chance to destroy the trinket and spawn Lunch.

Lost Cork

106

Uncorked

Increases the radius of any creep produced by Isaac.

Crow Heart

107

Drain me

Red heart damage will be taken before soul and black heart damage.

Walnut

108

That’s a hard nut to crack!

Taking damage has a small chance to destroy the trinket and spawn various pickups.

Duct Tape

109

Stuck!

Stops Isaac’s familiars from moving.

Silver Dollar

110

Feels lucky…

Shops appear in Chapter 4.

Bloody Crown

111

Drops with blood…

Treasure Rooms appear in Chapter 4.

Pay to Win

112

…

Restock boxes always spawn in Item Rooms.

Locust of War

113

I bring war

Upon entering a room with enemies, spawns a Red Locust which detonates upon impact with enemies.

Locust of Pestilence

114

I bring pestilence

Upon entering a room with enemies, spawns a Green Locust which damages and poisons enemies.

Locust of Famine

115

I bring famine

Upon entering a room with enemies, spawns a Yellow Locust that damages and slows enemies.

Locust of Death

116

I bring death

Upon entering a room with enemies, spawns a Black Locust that does a very high amount of damage.

Locust of Conquest

117

Upon entering a room with enemies, spawns 2-5 White Locusts which damage enemies.

Bat Wing

118

They are growing…

Upon killing an enemy, has a chance to grant flight for the rest of the room.

Stem Cell

119

Regen!

Heals for half a heart upon traveling to the next floor.

Hairpin

120

Poke that power outlet! Bosses charge you

Fully recharges Isaac’s active item upon entering a boss fight.

Wooden Cross

121

My faith protects me

Grants a Holy Mantle shield upon entering a new floor, which protects against one hit of damage.

Butter!

122

Can’t hold it!

Using an active item will drop it onto a pedestal on the ground.

Filigree Feather

123

Angelic Spoils!

Angels drop items instead of key pieces when defeated.

Door Stop

124

Hold the door!

The last door Isaac went through stays open, allowing him to leave the room even if enemies are in it.

Extension Cord

125

Charged friends

Beams of yellow electricity flow between Isaac and his familiars, damaging any enemies between them.

Transformations

Transformations alter Isaac’s appearance and grant him special abilities.

A transformation occurs when obtaining at least three collectibles from a particular set of items.
These collectibles always share a particular theme that corresponds with the transformation.

Transformation

Appearance

Transformation effect

Item

Beelzebub

Flight.

Converts small enemy flies into blue flies.

???’s Only Friend

Angry Fly

BBF

Best Bud

Big Fan

Distant Admiration

Forever Alone

Halo of Flies

Hive Mind

Skatole

Smart Fly

The Mulligan

Infestation

Friend Zone

Lost Fly

Papa Fly

Obsessed Fan

Guppy!

Flight.

Spawns a Blue Fly each time a tear hits an enemy.

Guppy’s Head

Guppy’s Paw

Dead Cat

Guppy’s Collar

Guppy’s Tail

Guppy’s Hair Ball

Bob

Isaac gains a green trail of poisonous creep.

Bob’s Rotten Head

Bob’s Brain

Bob’s Curse

Ipecac

Conjoined

When attacking, the tumor faces shoot tears
diagonally outwards, similar to the effect of The Wiz.

-0.3 damage.

Slightly decreases tears.

Brother Bobby

Harlequin Baby

Headless Baby

Little Steven

Mongo Baby

Rotten Baby

Sister Maggy

Fun Guy

+1 heart container.

God’s Flesh

Mini Mush

Magic Mushroom

Odd Mushroom (Thin)

Odd Mushroom (Large)

1up!

Blue Cap

Leviathan

Flight.

+2 black hearts.

The Nail

The Mark

Missing Page 2

The Pact

Pentagram

Spirit of the Night

Maw of the Void

Abaddon

Brimstone

Oh Crap

Whenever a pile of poop is destroyed,
health is replenished by half a heart.

Flush!

The Poop

E Coli

Seraphim

Flight.

+3 soul hearts.

The Bible

Dead Dove

Guardian Angel

Holy Grail

Holy Mantle

Mitre

Rosary

Sworn Protector

The Halo

Spun

+2 damage.

+0.15 speed.

Spawns a random pill upon transformation.

Adrenaline

Euthanasia

Experimental Treatment

Growth Hormones

Roid Rage

Speed Ball

Synthoil

The Virus

Yes, Mother?

Isaac gains a stationary knife that trails directly
behind him. It synergizes like Mom’s Knife would.

Mom’s Bottle of Pills

Mom’s Bra

Mom’s Pad

Mom’s Wig

Mom’s Eye

Mom’s Purse

Mom’s Contacts

Mom’s Knife

Mom’s Heels

Mom’s Eyeshadow

Mom’s Perfume

Mom’s Key

Mom’s Lipstick

Mom’s Underwear

Mom’s Coin Purse

Mom’s Pearls

Mom’s Razor

Super Bum

Replaces Bum Friend, Dark Bum, and Key Bum
for Super Bum.
He collects any of the other beggars’ pickups,
and offers twice the rewards.

Bum Friend

Dark Bum

Key Bum

Bookworm

Roughly 50% of the time,
Isaac shoots an extra tear, like 20/20.

Anarchist Cookbook

Book of Revelations

Book of Secrets

Book of Shadows

How to Jump

Monster Manual

Satanic Bible

Telepathy for Dummies

The Bible

The Book of Belial

The Book of Sin

The Necronomicon

Spider Baby

Spawns a spider familiar that applies random
status effects to enemies it comes in contact with.

Box of Spiders

Mutant Spider

Spider Baby

Spider Bite

Spider Butt

Spider Mod

Adult

Grants a heart container.

3 Puberty pills

Stompy

None

Taking damage has a chance to spawn rock waves.

Leo

Magic Mushroom

One Makes You Larger pills

Seeds

Miscellaneous

Seed

Description

Effects

BASE
MENT

Infinite basements

The Basement repeats infinitely.

KEEP
AWAY

Tricky pickups

Pickups mimic Isaac’s movements.

G0NE
S00N

Pickups time out

Pickups quickly fade.

FREE
2PAY

F2P version

Isaac starts with 69 coins, but all items and consumables must be bought.

PAC1
F1SM

Pacifism

Enemies do not take damage. All doors stay open. When in a boss room, the boss’s health slowly drains.

C0ME
BACK

Enemies respawn

Enemies, including bosses, respawn once Isaac leaves the room. Completing a room multiple times does not yield additional pickups.

N0RE
TVRN

Point of no return

Boss rooms lock Isaac in similar to the Mom fight.

BRWN
SNKE

Poopy trail

Isaac leaves a trail of poop behind him as he walks.

ALM1
GHTY

Dog mode

Isaac is invincible.

K1DS
M0DE

Kids’ co-op mode

Makes co-op babies invincible.

Curses

Seed

Description

Effects

DARK
NESS

Permanent darkness

Permanent Curse of Darkness.

LABY
RNTH

Inescapable labyrinth

Permanent Curse of the Labyrinth.

L0ST

Hopelessly lost

Permanent Curse of the Lost.

VNKN
0WN

Forever unknown

Permanent Curse of the Unknown.

MAZE

Unending maze

Permanent Curse of the Maze.

BL1ND

Incurable blindness

Permanent Curse of the Blind.

CVRS
ED

Horrible curse

Permanent Curse of the Cursed.

Curse Immunity

Seed

Description

Effects

N1TE
L1TE

Illuminate darkness

Provides immunity to Curse of Darkness.

THRE
AD

Escape the labyrinth

Provides immunity to Curse of the Labyrinth.

F0VND

I once was lost

Provides immunity to Curse of the Lost.

N0W1
KN0W

Know the unknown

Provides immunity to Curse of the Unknown.

PATH
F1ND

Stay out of the maze

Provides immunity to Curse of the Maze.

BRA1
LLE

Heal the blind

Provides immunity to Curse of the Blind.

BLCK
CNDL

Total curse immunity

Provides immunity to all curses.

Damage Modifiers

Seed

Description

Effects

HARD
HARD

Full heart damage

Isaac takes a full heart of damage from all sources.

BRTL
B0NS

Twelve heart damage

Isaac takes twelve hearts of damage from all sources.

D0NT
ST0P

Don’t stop moving

Isaac takes damage if he stops moving.

THEG
H0ST

Damage on a timer

Every 45 seconds, a ticking will begin, and after 5 seconds, Isaac will take 1/2 heart of damage. Damage increases to 1 heart in the womb and below. Having invincibility during the time when damage should be inflicted prevents the damage.

30M1
N1TS

30 minute limit

Gives a time limit of 30 minutes to beat the game. When the timer hits 29:45, a timer starts ticking, and after 30:00, Isaac takes damage every second.

Control Modifiers

Seed

Description

Effects

1CES
KATE

Ice physics

Makes the ground slippery.

BRAV
ERY

Bravery

Isaac fires tears in the same direction that he moves. Removes the normal ability to fire tears.

C0WR
D1CE

Cowardice

Isaac fires tears in the opposite direction that he moves. Removes the normal ability to fire tears.

DRAW
KCAB

Reversed controls

All movement and firing keys are reversed.

AX1S
ALGN

Axis aligned controls

Isaac cannot move diagonally.

Camouflage

Seed

Description

Effects

CAM0
K1DD

Camouflage player

Isaac blends into the ground.

CAM0
F0ES

Camouflage enemies

All enemies blend into the ground.

CAM0
DR0P

Camouflage stuff

Pickups and items blend into the ground.

WH0A
WHAT

Camouflage everything!

Isaac, enemies, pickups, and items all blend into the ground.

1MN0
B0DY

Invisible player

Isaac becomes completely invisible.

BL1N
DEYE

Invisible enemies

All enemies become completely invisible.

Player Appearance

Seed

Description

Effects

THEB
LANK

The blank

Isaac has no face.

KAPPA

Grayscale

Isaac turns gray.

H0H0
H0H0

Christmas

Isaac wears a Christmas hat.

T0PH
EAVY

Big head mode

Isaac’s head is large.

T1NY
D0ME

Tiny head mode

Isaac’s head is small.

PTCH
BLCK

Black body

Isaac and his tears turn completely black.

Visual Effects

Seed

Description

Effects

TEAR
GL0W

Glowing tears

Isaac’s tears glow.

BL00
00DY

Extra gore

Makes a lot more blood appear after enemies die.

HUD Modifiers

Seed

Description

Effects

B00B
T00B

Cathode rays!

Applies a filter that makes the game look like it’s being played through a cathode ray tube.

DYSL
EX1A

Dyslexia

All in-game text is rearranged.

KEEP
TRAK

No HUD

Removes the HUD entirely. This affects the map, health, consumables, held items, pickup text, floor names, and more.

MED1
C1NE

Mystery pills

All pill names and descriptions show ???.

FACE
D0WN

Mystery cards

All card names and descriptions show ???.

Enemy Modifiers

Seed

Description

Effects

CHAM
P10N

Champion enemies Disables achievements

All enemies turn into champions if possible.

Ϲ0CK
FGHT

Charmed enemies Disables achievements

All enemies are permanently charmed.

C0NF
ETT1

Confused enemies Disables achievements

All enemies are permanently confused.

FEAR
M1NT

Scaredy enemies Disables achievements

All enemies are permanently scared.

FRA1
DN0T

Skittish enemies Disables achievements

Every few seconds, all enemies become scared.

CLST
RPH0

Asocial enemies Disables achievements

All enemies are permanently charmed and scared.

Sound Modifiers

Seed

Description

Effects

FART
SNDS

Farty sounds

All sound effects are replaced with farts.

SL0W
4ME2

Movement tempo

Music speed is affected by Isaac’s walking speed.

HART
BEAT

Health tempo

The lower Isaac’s health is, the slower the music is.

ANDA
NTE

Downtempo

Music is slowed down.

LARG
HET0

Downtempo–

Music is significantly slowed down.

ALLE
GR0

Uptempo

Music is sped up.

PRES
T0

Uptempo++

Music is significantly sped up.

Cards and Runes

Major Arcana Cards
When on the ground, these cards look like this:

Name

Icon

Message

Effect

0 – The Fool

Where journey begins

Teleports you back to the starting room of a floor.

I – The Magician

May you never miss your goal

Grants homing tears for the current room.

II – The High Priestess

Mother is watching you

Mom’s dismembered leg is called down to deal 300 damage to anything it stomps. It will always stomp on the enemy with the most health. If used in an empty room or during the fight with Mom, it will stomp Isaac instead.

III – The Empress

May your rage bring power

Triggers the ♥♥♥♥♥ of Babylon effect (+1.5 damage, +0.3 speed) for the current room, but without the need for Isaac to have a red heart or less of health.

IV – The Emperor

Challenge me!

Teleports Isaac into the Boss Room of a floor.

V – The Hierophant

Two prayers for the lost

Spawns 2 Soul Hearts.

VI – The Lovers

May you prosper and be in good health

Spawns 2 Red Hearts. If used in a Black Heart or Eternal Heart-containing Super Secret Room, it will spawn those types of hearts instead.

VII – The Chariot

May nothing stand before you

Grants the temporary invulnerability effect of My Little Unicorn My Little Unicorn.

VIII – Justice

May your future become balanced

Spawns one of each consumable drop (a Red Heart, a Key, a Bomb, and a Penny). Hearts have a chance to spawn as either a Half Red Heart or a Double Heart.

IX – The Hermit

May you see what life has to offer

Teleports Isaac to the Shop. If there is no Shop, this will act as a random teleport. If the Shop has not yet been accessed, this card will unlock the door without requiring a key (as long as the player exits through the main entrance).

X – Wheel of Fortune

Spin the wheel of destiny

Spawns an Arcade machine (Slot Machine or Fortune Telling Machine).

XI – Strength

May your power bring rage

Grants the effect of Magic Mushroom Magic Mushroom (increases all of Isaac’s stats except tears), but adds one (temporary) Red Heart container for the current room as opposed to a permanent one.

XII – The Hanged Man

May you find enlightenment

Removes Isaac’s body, allowing him to fly around for the duration of the room (same effect as Transcendence Transcendence).

XIII – Death

Lay waste to all that oppose you

Deals 40 damage to all enemies in the room (same effect as The Necronomicon The Necronomicon).

XIV – Temperance

May you be pure in heart

Spawns a Blood Donation Machine.
Added in Afterbirth Spawns a Devil Beggar in Greed mode.

XV – The Devil

Revel in the power of darkness

Grants Isaac a temporary +2 increase to damage for the current room (same effect as The Book of Belial The Book of Belial).

XVI – The Tower

Destruction brings creation

Spawns 6 Troll Bombs randomly around the room (same effect as the Anarchist Cookbook Anarchist Cookbook).

XVII – The Stars

May you find what you desire

Teleports Isaac to the Treasure Room. If there is no Treasure Room, this will act as a random teleport. Randomly chooses a Treasure Room on Curse of the Labyrinth. If the Treasure Room has not yet been accessed, this card will unlock the door without requiring a key (as long as the player exits through the main entrance).

XVIII – The Moon

May you find all you have lost

Teleports the player to the Secret Room. This card will open one random wall once inside the Secret Room, so you can leave even if you don’t have any bombs available.

XIX – The Sun

May the light heal and enlighten you

Restores Isaac’s full health, deals 100 damage to all enemies in the room, and reveals the map for the current floor, except the Super Secret Room.

XX – Judgement

Judge lest ye be judged

Spawns a Beggar.

XXI – The World

Open your eyes and see

Reveals the entire floor, except for the Super Secret Room. Has no effect if under the effect of Curse of the Lost or Amnesia.

Achievements

Name

Image

Description

Unlock

In Game Secret Number

Magdalene

Unlocked a new character.

Have 7 or more Red Heart containers at one time

Cain

Unlocked a new character.

Hold 55 coins at one time

Judas

Unlocked a new character.

Defeat Satan

The Womb

Chapter 4 – The Womb unlocked.

Defeat Mom

The Harbingers

The horsemen are loose.

Defeat Mom

A Cube of Meat

Unlocked a new item. (Also unlocks the Ball of Bandages)

Defeat Mom

The Book of Revelations

Unlocked a new item.

Defeat a Harbinger

A Noose

Unlocked a new item.

Defeat Mom’s Heart 3 times

The Nail

Unlocked a new item.

Complete the Boss Rush as Azazel

A Quarter

Unlocked a new item.

Defeat Mom’s Heart 8 times

A Fetus in a Jar

Unlocked a new item.

Defeat Mom’s Heart 9 times

A Small Rock

Unlocked a new item.

Destroy 100 Tinted Rocks

Monstro’s Tooth

Unlocked a new item.

Beat chapter 1

Lil’ Chubby

Unlocked a new item.

Beat chapter 2

Loki’s Horns

Unlocked a new item.

Defeat Lokii

Something From The Future

New boss in the basement!

Beat The Basement 40 times

Something Cute

New boss in the caves!

Beat chapter 2 30 times

Something Sticky

New boss in the depths!

Beat chapter 3 20 times

A Bandage

Unlocked a new item.

Make a Super Bandage Girl by picking up 4 Balls of Bandages in one run; see unlocking Super Meat Boy & Super Bandage Girl

A Cross

Unlocked a new item.

Defeat Isaac as Magdalene

A Bag of Pennies

Unlocked a new item.

Defeat Isaac as Cain

The Book of Sin

Unlocked a new item.

Defeat all 7 deadly sins

Little Gish

Unlocked a new item.

Defeat Gish

Little Steven

Unlocked a new item.

Defeat Steven

Little C.H.A.D.

Unlocked a new item.

Defeat C.H.A.D.

A Gamekid

Unlocked a new item.

Visit 10 Arcades

A Halo

Unlocked a new item.

Defeat Mom, Mom’s Heart or It Lives using The Bible

Mr. Mega

Unlocked a new item.

Destroy 10 Tinted Rocks

The D6

Isaac now holds the D6!

Defeat Isaac as ???

The Scissors

Unlocked a new item.

Die 100 times

The Parasite

Unlocked a new item.

Pick up any 2 of the following items in a single run: Bob’s Rotten Head, Dead Cat, Cricket’s Head, Tammy’s Head

???

Unlocked a new character.

Defeat Mom’s Heart 10 times

Everything Is Terrible!!!

The game just got harder!

Defeat Mom’s Heart 5 times

It Lives!

Your future’s past waits.

Defeat Mom’s Heart 11 times

Mom’s Contact

Unlocked a new item.

Obtain three Yes Mother? items in one run

The Necronomicon

Unlocked a new item.

Use XIII – Death 4 times

Basement Boy

Beat basement without taking damage.

Beat chapter 1 without taking damage

Spelunker Boy

Beat caves without taking damage.

Beat chapter 2 without taking damage

Dark Boy

Beat depths without taking damage.

Beat chapter 3 without taking damage

Mama’s Boy

Beat womb without taking damage.

Beat chapter 4 without taking damage

Golden God!

You are the best!!

Defeat ??? and The Lamb

Eve

Unlocked a new character.

Don’t pick up any hearts for 2 floors in a row

Mom’s Knife

Unlocked a new item.

Defeat Satan as Isaac

The Razor

Unlocked a new item.

Defeat Satan as Eve

Guardian Angel

Unlocked a new item.

Defeat Satan as Magdalene

A Bag of Bombs

Unlocked a new item.

Defeat Satan as Cain

Demon Baby

Unlocked a new item.

Defeat The Lamb as Azazel

Forget Me Now

Unlocked a new item.

Defeat Satan as ???

The D20

Unlocked a new item.

Defeat ??? as Isaac

Celtic Cross

Unlocked a new item.

Defeat ??? as Magdalene

Abel

Unlocked a new item.

Defeat The Lamb as Cain

Curved Horn

Unlocked a new item.

Defeat The Lamb as Judas

Sacrificial Dagger

Unlocked a new item.

Defeat ??? as Eve

Bloody Lust

Unlocked a new item.

Defeat Isaac as Samson

Blood Penny

Unlocked a new item.

Defeat ??? as Samson

Blood Rights

Unlocked a new item.

Defeat Satan as Samson

The Polaroid

Unlocked a new item.

Defeat Isaac 5 times

Dad’s Key

Unlocked a new item.

Pick up both Key Pieces from the Angels in one run

Blue Candle

Unlocked a new item.

Donate 900 coins to the Donation Machine

Burnt Penny

Unlocked a new item.

Complete Beans! (challenge #13)

Lucky Toe

Unlocked a new item.

Blow up 20 Shopkeepers

Epic Fetus

Unlocked a new item.

Complete The Family Man (challenge #19)

SMB Super Fan

Unlocked a new item.

Complete It’s in the Cards (challenge #14)

Counterfeit Coin

Unlocked a new item.

Play the Shell Game 100 times

Guppy’s Hairball

Unlocked a new item.

Become Guppy

A Forgotten Horseman

Unlocked a new boss!

Take 10 items from Angel Rooms

Samson

Unlocked a new character.

Complete 2 floors in a row without taking damage

Something Icky

New boss in the womb!

Defeat Isaac 10 times

!Platinum God!

OMG!

Collect all non-DLC items in the game, unlock all of the secrets and endings minus The Lost and his 6 unlockable items

Isaac’s Head

Unlocked a new item.

Complete the Boss Rush as Isaac

Maggy’s Faith

Unlocked a new item.

Defeat The Lamb as Magdalene

Judas’ Tongue

Unlocked a new item.

Defeat Satan as Judas

???’s Soul

Unlocked a new item.

Defeat The Lamb as ???

Samson’s Lock

Unlocked a new item.

Defeat The Lamb as Samson

Cain’s Eye

Unlocked a new item.

Defeat ??? as Cain

Eve’s Bird Foot

Unlocked a new item.

Defeat Isaac as Eve

The Left Hand

Unlocked a new item.

Defeat Ultra Pride as any character, or ??? as Judas

The Negative

Unlocked a new item.

Defeat Satan 5 times

Azazel

Unlocked a new character.

Make 3 deals with the Devil in one run

Lazarus

Unlocked a new character.

Have 4 or more Soul Hearts at one time

Eden

Unlocked a new character.

Complete chapter 4

The Lost

Unlocked a new character.

It’s complicated Die in a Sacrifice Room while holding Missing Poster

Dead Boy

Beat Chest or Dark Room without taking damage.

Complete chapter 6 without taking damage

The Real Platinum God

111% now stop playing!

Collect every non-DLC item and unlock every ending.

Lucky Rock

Destroy 100 rocks.

Destroy 100 rocks

The Cellar

Alt stage to the basement.

Beat all The Basement bosses (not restricted to beating bosses in The Basement)

The Catacombs

Alt stage to the caves.

Beat all The Caves bosses (not restricted to beating bosses in The Caves)

The Necropolis

Alt stage to the depths.

Beat all The Depths bosses (not restricted to beating bosses in The Depths)

Rune of Hagalaz

Unlocked a new item.

Complete Pitch Black (challenge #1)

Rune of Jera

Unlocked a new item.

Complete High Brow (challenge #2)

Rune of Ehwaz

Unlocked a new item.

Complete Head Trauma (challenge #3)

Rune of Dagaz

Unlocked a new item.

Complete Darkness Falls (challenge #4)

Rune of Ansuz

Unlocked a new item.

Complete The Tank (challenge #5)

Rune of Perthro

Unlocked a new item.

Complete Solar System (challenge #6)

Rune of Berkano

Unlocked a new item.

Complete Purist (challenge #20)

Rune of Algiz

Unlocked a new item.

Complete Cat Got Your Tongue (challenge #8)

Chaos Card

Unlocked a new item.

Complete Demo Man (challenge #9)

Credit Card

Unlocked a new item.

Complete Cursed (challenge #10)

Rules Card

Unlocked a new item.

Complete Glass Cannon (challenge #11)

Card Against Humanity

Unlocked a new item.

Complete When Life Gives You Lemons (challenge #12)

100

Swallowed Penny

Unlocked a new item.

Complete Slow Roll (challenge #15)

101

Robo-Baby 2.0

Unlocked a new item.

Complete Computer Savvy (challenge #16)

102

Death’s Touch

Unlocked a new item.

Complete Waka Waka (challenge #17)

103

Technology .5

Unlocked a new item.

Complete The Host (challenge #18)

104

Missing No.

Unlocked a new item.

Complete the Boss Rush as Lazarus

105

Isaac’s Tears

Unlocked a new item.

Defeat Isaac as Isaac

106

Guillotine

Unlocked a new item.

Defeat Isaac as Judas

107

Judas’ Shadow

Unlocked a new item.

Complete the Boss Rush as Judas

108

Maggy’s Bow

Unlocked a new item.

Complete the Boss Rush as Magdalene

109

Cain’s Other Eye

Unlocked a new item.

Complete the Boss Rush as Cain

110

Black Lipstick

Unlocked a new item.

Defeat The Lamb as Eve

111

Eve’s Mascara

Unlocked a new item.

Complete the Boss Rush as Eve

112

Fate

Unlocked a new item.

Defeat ??? as ???

113

???’s Only Friend

Unlocked a new item.

Complete the Boss Rush as ???

114

Samson’s Chains

Unlocked a new item.

Complete the Boss Rush as Samson

115

Lazarus’ Rags

Unlocked a new item.

Defeat Isaac as Lazarus

116

Broken Ankh

Unlocked a new item.

Defeat Satan as Lazarus

117

Store Credit

Unlocked a new item.

Defeat ??? as Lazarus

118

Pandora’s Box

Unlocked a new item.

Defeat The Lamb as Lazarus

119

Suicide King

Unlocked a new item.

Complete Suicide King (challenge #7)

120

Blank Card

Unlocked a new item.

Defeat Isaac as Eden

121

Book of Secrets

Unlocked a new item.

Defeat Satan as Eden

122

Mysterious Paper

Unlocked a new item.

Beat ??? as Eden

123

Mystery Sack

Unlocked a new item.

Defeat The Lamb as Eden

124

Undefined

Unlocked a new item.

Complete the Boss Rush as Eden

125

Satanic Bible

Unlocked a new item.

Defeat Isaac as Azazel

126

Daemon’s Tail

Unlocked a new item.

Defeat Satan as Azazel

127

Abaddon

Unlocked a new item.

Defeat ??? as Azazel

128

Isaac’s Heart

Unlocked a new item.

Defeat Isaac as The Lost

129

The Mind

Unlocked a new item.

Defeat Satan as The Lost

130

The Body

Unlocked a new item.

Defeat ??? as The Lost

131

The Soul

Unlocked a new item.

Defeat The Lamb as The Lost

132

The D100

Unlocked a new item.

Complete the Boss Rush as The Lost

133

Blue Map

Unlocked a new item.

Donate 10 coins to the Donation Machine

134

There’s Options

Unlocked a new item.

Donate 50 coins to the Donation Machine

135

Black Candle

Unlocked a new item.

Donate 150 coins to the Donation Machine

136

Red Candle

Unlocked a new item.

Donate 400 coins to the Donation Machine

137

Stop Watch

Unlocked a new item

Donate 999 coins to the Donation Machine

138

Wire Coat Hanger

Unlocked a new item.

Defeat Mom’s Heart 4 times

139

Ipecac

Unlocked a new item.

Defeat Mom’s Heart 6 times

140

Experimental Treatment

Unlocked a new item.

Defeat Mom’s Heart 7 times

141

Krampus

Unlocked another miniboss!

Take 20 items from Devil Rooms

142

Head of Krampus

Unlocked a new item.

Defeat Krampus

143

Super Meat Boy

Built him out of meat cubes.

Make a Super Meat Boy by picking up Cube of Meat 4 times in one run; see methods to create a Super Meat Boy

144

Butter Bean

Unlocked a new item.

Destroy 100 poops

145

Little Baggy

Unlocked a new item.

Collect 2 of either Roid Rage, The Virus, Growth Hormones, Experimental Treatment or Speed Ball

146

Blood Bag

Unlocked a new item.

Use the Blood Donation Machine 30 times

147

The D4

Unlocked a new item.

Blow up 30 Arcade machines

148

Missing Poster

Unlocked a new item.

Defeat The Lamb as Isaac

149

Rubber Cement

Unlocked a new item.

Defeat Mom’s Heart 2 times

150

Store Upgrade lv.1

Donated 20 pennies to the shop.

Donate 20 coins to the Donation Machine

151

Store Upgrade lv.2

Donated 100 pennies to the shop.

Donate 100 coins to the Donation Machine

152

Store Upgrade lv.3

Donated 200 pennies to the shop.

Donate 200 coins to the Donation Machine

153

Store Upgrade lv.4

Donated 600 pennies to the shop.

Donate 600 coins to the Donation Machine

154

Angels

They are waiting.

Complete chapter 6

155

Godhead

Unlocked a new item.

Earn all 5 / 9 (except the cent sign for Ultra Greed) / 10 completion marks on Hard mode as The Lost

156

Darkness Falls

Unlocked Challenge #4.

Defeat Mom’s Heart 11 times

157

The Tank

Unlocked Challenge #5.

Have 7 or more Red Heart containers at one time

158

Solar System

Unlocked Challenge #6.

Defeat Mom’s Heart 3 times

159

Suicide King

Unlocked Challenge #7.

Defeat Mom’s Heart 11 times

160

Cat Got Your Tongue

Unlocked Challenge #8.

Become Guppy

161

Demo Man

Unlocked Challenge #9.

Defeat Mom’s Heart 9 times

162

Cursed!

Unlocked Challenge #10.

Have 7 or more Red Heart Containers at one time

163

Glass Cannon

Unlocked Challenge #11.

Beat The Family Man (challenge #19) and defeat Lokii

164

The Family Man

Unlocked Challenge #19.

Pick up both Key Pieces from the Angels in one run

165

Purist

Unlocked Challenge #20.

Defeat Mom

166

Lost Baby

Unlocked a new co-player baby.

Defeat Mom’s Heart on Hard mode as Isaac

167

Cute Baby

Unlocked a new co-player baby.

Defeat Mom’s Heart on Hard mode as Magdalene

168

Crow Baby

Unlocked a new co-player baby.

Defeat Mom’s Heart on Hard mode as Eve

169

Shadow Baby

Unlocked a new co-player baby.

Defeat Mom’s Heart on Hard mode as Judas

170

Glass Baby

Unlocked a new co-player baby.

Defeat Mom’s Heart on Hard mode as Cain

171

Wrapped Baby

Unlocked a new co-player baby.

Defeat Mom’s Heart on Hard mode as Azazel Defeat Mom’s Heart on Hard mode as Lazarus

172

Begotten Baby

Unlocked a new co-player baby.

Defeat Mom’s Heart on Hard mode as Lazarus Defeat Mom’s Heart on Hard mode as Azazel

173

Dead Baby

Unlocked a new co-player baby.

Defeat Mom’s Heart on Hard mode as ???

174

-0- Baby

Unlocked a new co-player baby.

Defeat Mom’s Heart on Hard mode as The Lost

175

Glitch Baby

Unlocked a new co-player baby.

Defeat Mom’s Heart on Hard mode as Eden

176

Fighting Baby

Unlocked a new co-player baby.

Defeat Mom’s Heart on Hard mode as Samson

177

Lord of the Flies

You became Lord of the Flies.

Become Beelzebub

178

Fart Baby

Unlocked a new item.

Defeat Hush as Isaac

179

Purity

Unlocked a new item.

Defeat Hush as Magdalene

180

D12

Unlocked a new item.

Defeat Hush as Cain

181

Betrayal

Unlocked a new item.

Defeat Hush as Judas

182

Fate’s Reward

Unlocked a new item.

Defeat Hush as ???

183

Athame

Unlocked a new item.

Defeat Hush as Eve

184

Blind Rage

Unlocked a new item.

Defeat Hush as Samson

185

Maw of the Void

Unlocked a new item.

Defeat Hush as Azazel

186

Empty Vessel

Unlocked a new item.

Defeat Hush as Lazarus

187

Eden’s Blessing

Unlocked a new item.

Defeat Hush as Eden

188

Sworn Protector

Unlocked a new item.

Defeat Hush as The Lost

189

Incubus

Unlocked a new item.

Defeat Hush as Lilith

190

Keeper now holds… A Penny!

Unlocked a new item.

Defeat Hush as Keeper

191

Lil’ Chest

Unlocked a new item.

Defeat Ultra Greed as Isaac

192

Censer

Unlocked a new item.

Defeat Ultra Greed as Magdalene

193

Evil Eye

Unlocked a new item.

Defeat Ultra Greed as Cain

194

My Shadow

Unlocked a new item.

Defeat Ultra Greed as Judas

195

Cracked Dice

Unlocked a new item.

Defeat Ultra Greed as ???

196

Black Feather

Unlocked a new item.

Defeat Ultra Greed as Eve

197

Lusty Blood

Unlocked a new item.

Defeat Ultra Greed as Samson

198

Lilith

Unlocked a new character.

Defeat Ultra Greed as Azazel

199

Key Bum

Unlocked a new item.

Defeat Ultra Greed as Lazarus

200

GB Bug

Unlocked a new item.

Defeat Ultra Greed as Eden

201

Zodiac

Unlocked a new item.

Defeat Ultra Greed as The Lost

202

Box of Friends

Unlocked a new item.

Defeat Ultra Greed as Lilith

203

Rib of Greed

Unlocked a new item.

Defeat Ultra Greed as Keeper

204

Cry Baby

Unlocked a new co-player baby.

Defeat Mega Satan as Isaac

205

Red Baby

Unlocked a new co-player baby.

Defeat Mega Satan as Magdalene

206

Green Baby

Unlocked a new co-player baby.

Defeat Mega Satan as Cain

207

Brown Baby

Unlocked a new co-player baby.

Defeat Mega Satan as Judas

208

Blue Baby

Unlocked a new co-player baby.

Defeat Mega Satan as ???

209

Lil’ Baby

Unlocked a new co-player baby.

Defeat Mega Satan as Eve

210

Rage Baby

Unlocked a new co-player baby.

Defeat Mega Satan as Samson

211

Black Baby

Unlocked a new co-player baby.

Defeat Mega Satan as Azazel

212

Long Baby

Unlocked a new co-player baby.

Defeat Mega Satan as Lazarus

213

Yellow Baby

Unlocked a new co-player baby.

Defeat Mega Satan as Eden

214

White Baby

Unlocked a new co-player baby.

Defeat Mega Satan as The Lost

215

Big Baby

Unlocked a new co-player baby.

Defeat Mega Satan as Lilith

216

Noose Baby

Unlocked a new co-player baby.

Defeat Mega Satan as Keeper

217

Rune Bag

Unlocked a new item.

Defeat Isaac as Lilith

218

Cambion Conception

Unlocked a new item.

Defeat ??? as Lilith

219

Serpent’s Kiss

Unlocked a new item.

Defeat Satan as Lilith

220

Succubus

Unlocked a new item.

Defeat The Lamb as Lilith

221

Immaculate Conception

Unlocked a new item.

Complete the Boss Rush as Lilith

222

Goat Head Baby

Unlocked a new co-player baby.

Defeat Mom’s Heart on Hard mode as Lilith

223

Gold Heart

Unlocked a new item.

Complete XXXXXXXXL (challenge #21)

224

Get out of Jail Free Card

Unlocked a new item.

Complete SPEED! (challenge #22)

225

Gold Bomb

Unlocked a new item.

Complete Blue Bomber (challenge #23)

226

2 new pills

Unlocked a new item.

Complete PAY TO PLAY (challenge #24)

227

2 new pills

Unlocked a new item.

Complete Have a Heart (challenge #25)

228

Poker Chip

Unlocked a new item.

Complete I RULE! (challenge #26)

229

Stud Finder

Unlocked a new item.

Complete BRAINS! (challenge #27)

230

Unlocked a new item.

Complete PRIDE DAY! (challenge #28)

231

Kidney Stone

Unlocked a new item.

Complete The Guardian (challenge #30) Complete Onan’s Streak (challenge #29)

232

Blank Rune

Unlocked a new item.

Complete Onan’s Streak (challenge #29) Complete The Guardian (challenge #30)

233

Blue Womb

Unlocked a hidden chapter.

Defeat Mom’s Heart 10 times

234

1001%

Nerd x 1000000

Unlock all of the secrets and endings, and collect every item in the game

235

Keeper holds Wooden Nickel

Unlocked a new starting item.

Defeat Isaac as Keeper

236

Keeper holds Store Key

Unlocked a new starting item.

Defeat Satan as Keeper

237

Deep Pockets

Unlocked a new item.

Defeat ??? as Keeper

238

Karma

Unlocked a new item.

Defeat The Lamb as Keeper

239

Sticky Nickels

Unlocked a new item.

Complete the Boss Rush as Keeper

240

Super Greed Baby

Unlocked a new co-player baby.

Defeat Mom’s Heart on Hard mode as Keeper

241

Lucky Pennies

Unlocked a new item.

Donate 1 coin to the Greed Donation Machine

242

Special Hanging Shopkeepers

Unlocked a secret.

Donate 10 coins to the Greed Donation Machine

243

Wooden Nickel

Unlocked a new item.

Donate 30 coins to the Greed Donation Machine

244

Cain holds Paperclip

Unlocked a new starting item.

Donate 68 coins to the Greed Donation Machine

245

Everything is Terrible 2!!!

Greed just got harder!

Donate 111 coins to the Greed Donation Machine

246

Special Shopkeepers

Unlocked a secret.

Donate 234 coins to the Greed Donation Machine

247

Eve now holds Razor Blade

Unlocked a new starting item.

Donate 439 coins to the Greed Donation Machine

248

Store Key

Unlocked a new item.

Donate 666 coins to the Greed Donation Machine

249

Lost holds Holy Mantle

Unlocked a new starting item.

Donate 879 coins to the Greed Donation Machine

250

Keeper

Unlocked a new character.

Donate 1000 coins to the Greed Donation Machine

251

Hive Baby

Unlocked a new co-player baby.

Earn all Hard mode completion marks as ???

252

Buddy Baby

Unlocked a new co-player baby.

Earn all Hard mode completion marks as Isaac

253

Colorful Baby

Unlocked a new co-player baby.

Earn all Hard mode completion marks as Magdalene

254

♥♥♥♥♥ Baby

Unlocked a new co-player baby.

Earn all Hard mode completion marks as Eve

255

Cracked Baby

Unlocked a new co-player baby.

Earn all Hard mode completion marks as Eden

256

Dripping Baby

Unlocked a new co-player baby.

Earn all Hard mode completion marks as Lazarus

257

Blinding Baby

Unlocked a new co-player baby.

Use Blank Card while holding XIX – The Sun

258

Sucky Baby

Unlocked a new co-player baby.

Earn all Hard mode completion marks as Azazel

259

Dark Baby

Unlocked a new co-player baby.

Earn all Hard mode completion marks as Lilith

260

Picky Baby

Unlocked a new co-player baby.

Earn all Hard mode completion marks as Cain

261

Revenge Baby

Unlocked a new co-player baby.

Earn all Hard mode completion marks as Samson

262

Belial Baby

Unlocked a new co-player baby.

Earn all Hard mode completion marks as Judas

263

Sale Baby

Unlocked a new co-player baby.

Earn all Hard mode completion marks as Keeper

264

XXXXXXXXL

Unlocked Challenge #21.

Defeat Mom

265

SPEED!

Unlocked Challenge #22.

Defeat Mom

266

Blue Bomber

Unlocked Challenge #23.

Destroy 10 Tinted Rocks and defeat Mom’s Heart 11 times

267

PAY TO PLAY

Unlocked Challenge #24.

Defeat Isaac as Cain

268

Have a Heart

Unlocked Challenge #25.

Defeat Mom

269

I RULE!

Unlocked Challenge #26.

Defeat ??? or The Lamb, and defeat Satan as Isaac

270

BRAINS!

Unlocked Challenge #27.

Defeat Isaac 5 times

271

PRIDE DAY!

Unlocked Challenge #28.

Defeat Mom

272

Onan’s Streak

Unlocked Challenge #29.

Defeat Mom

273

The Guardian

Unlocked Challenge #30.

Defeat Mom

274

Generosity

If only everyone was as generous as you are…

Donate 999 coins to the Greed Donation Machine

275

Mega

Unlocked…

Defeat Mega Satan as every character

276

Backasswards

Unlocked a new challenge.

Defeat ??? or The Lamb

277

Aprils fool

Unlocked a new challenge.

Defeat Mom

278

Pokey Mans

Unlocked a new challenge.

Defeat Mom’s Heart 11 times

279

Ultra Hard

Unlocked a new challenge.

Defeat ??? or The Lamb. Possession of The Polaroid/ The Negative is required, prohibiting getting to Dark Room through a Sacrifice Room.

280

PONG

Unlocked a new challenge.

Defeat Isaac 5 times

281

D Infinity

Unlocked a new item.

Defeat Delirium as Isaac

282

Eucharist

Unlocked a new item.

Defeat Delirium as Magdalene

283

Silver Dollar

Unlocked a new item.

Defeat Delirium as Cain

284

Shade

Unlocked a new item.

Defeat Delirium as Judas

285

King Baby

Unlocked a new co-player baby.

Defeat Delirium as ???

286

Bloody Crown

Unlocked a new item.

Defeat Delirium as Samson

287

Dull Razor

Unlocked a new item.

Defeat Delirium as Eve

288

Eden’s Soul

Unlocked a new item.

Defeat Delirium as Eden

289

Dark Prince’s Crown

Unlocked a new item.

Defeat Delirium as Azazel

290

Compound Fracture

Unlocked a new item.

Defeat Delirium as Lazarus

291

Euthanasia

Unlocked a new item.

Defeat Delirium as Lilith

292

Holy Card

Unlocked a new item.

Defeat Delirium as The Lost

293

Crooked Penny

Unlocked a new item.

Defeat Delirium as Keeper

294

Void

Unlocked a new item.

Defeat Delirium as Apollyon

295

Unlocked a new item.

Defeat Ultra Greedier as Isaac

296

Glyph of Balance

Unlocked a new item.

Defeat Ultra Greedier as Magdalene

297

Sack of Sacks

Unlocked a new item.

Defeat Ultra Greedier as Cain

298

Eye of Belial

Unlocked a new item.

Defeat Ultra Greedier as Judas

299

Meconium

Unlocked a new item.

Defeat Ultra Greedier as ???

300

Stem Cell

Unlocked a new item.

Defeat Ultra Greedier as Samson

301

Crow Heart

Unlocked a new item.

Defeat Ultra Greedier as Eve

302

Metronome

Unlocked a new item.

Defeat Ultra Greedier as Eden

303

Bat Wing

Unlocked a new item.

Defeat Ultra Greedier as Azazel

304

Plan C

Unlocked a new item.

Defeat Ultra Greedier as Lazarus

305

Duality

Unlocked a new item.

Defeat Ultra Greedier as Lilith

306

Dad’s Lost Coin

Unlocked a new item.

Defeat Ultra Greedier as The Lost

307

Eye of Greed

Unlocked a new item.

Defeat Ultra Greedier as Keeper

308

Black Rune

Unlocked a new item.

Defeat Ultra Greedier as Apollyon

309

Locust of Wrath

Unlocked a new item.

Defeat Isaac as Apollyon

310

Locust of Pestilence

Unlocked a new item.

Defeat Satan as Apollyon

311

Locust of Famine

Unlocked a new item.

Defeat ??? as Apollyon

312

Locust of Death

Unlocked a new item.

Defeat The Lamb as Apollyon

313

Locust of Conquest

Unlocked a new item.

Complete the Boss Rush as Apollyon

314

Hushy

Unlocked a new item.

Defeat Hush as Apollyon

315

Brown Nugget

Unlocked a new item.

Defeat Ultra Greed as Apollyon

316

Mort Baby

Unlocked a new co-player baby.

Defeat Mega Satan as Apollyon

317

Smelter

Unlocked a new item.

Defeat Mom’s Heart or It Lives! on Hard mode as Apollyon

318

Apollyon Baby

Unlocked a new co-player baby.

Earn all Hard mode completion marks as Apollyon

319

New Area

Unlocked a new area.

Defeat Hush

320

Once More with Feeling!

Unlocked a new item.

Complete a Victory Lap, defeating The Lamb

321

Hat trick!

Unlocked a new item.

Get a 3-win streak

322

5 Nights at Mom’s

Unlocked super special rocks.

Get a 5-win streak, using a different character for each win

323

Sin collector

Unlocked a new item.

Collect every entry in the Bestiary (bugged v190 – Mobs that don’t exist in the bestiary are being counted. This allows Sin Collector to be unlocked without a complete bestiary)

324

Dedication

Unlocked a new item.

Participate in 31 daily challenges (they don’t have to be consecutive; it will still count if you die in the first room)

325

ZIP!

Unlocked a new item.

Defeat The Lamb in under 20 minutes

326

It’s the Key

Unlocked a new item.

Defeat The Lamb without taking hearts, coins, and bombs through an entire run

327

Mr. Resetter!

Unlocked a new item.

Reset 7 times in a row

328

Living on the edge

Unlocked a new item.

Complete a floor after The Basement I, start-to-finish, with only half a heart of health (can use The Lost)

329

U Broke It!

Unlocked a new item.

Obtain 50 items on a run (e.g., via two Steam Sale and Restock – Duplicate passives/familiars count towards the total, e.g., multiple Breakfast)

330

Laz Bleeds More!

Unlocked a new starting item.

Complete Backasswards (challenge #31)

331

Maggy Now Holds a Pill!

Unlocked a new starting item.

Complete Aprils Fool (challenge #32)

332

Charged Key

Unlocked a new item.

Complete Pokey Mans (challenge #33)

333

Samson Feels Healthy!

Unlocked a new starting item.

Complete Ultra Hard (challenge #34)

334

Greed’s Gullet

Unlocked a new item.

Complete Pong (challenge #35)

335

The Marathon

Unlocked a new item.

Get a 5-win streak in the daily challenges

336

RERUN

Unlocked the power of RERUN.

Complete 3 Victory Laps

337

Delirious

Unlocked a new item.

Defeat Delirium

338

1000000%

Just Stop!

Collect every item in the game, unlock all secrets and endings, and complete the bestiary (minus anything added in Booster Packs; as of Booster Pack #5, all achievements from Booster Packs, as well as the renewed bestiary, need to completed)

339

Apollyon

Unlocked a new character.

Defeat Mega Satan

340

Greedier!

New mode unlocked!

Donate 500 coins to the Greed Donation Machine

341

Burning Basement

Alt stage to the basement.

Defeat Mom’s Heart 11 times

342

Flooded Caves

Alt stage to the caves.

Defeat It Lives 16 times

343

Dank Depths

Alt stage to the depths.

Defeat It Lives 21 times

344

Scarred Womb

Alt stage to the womb.

Defeat It Lives 30 times

345

Something wicked this way comes!

Unlocked new bosses!

Defeat ??? as 3 different characters

346

Something wicked this way comes+!

Unlocked even more bosses!

Defeat ??? as 6 different characters

347

The gate is open!

Unlocked new enemies!

Defeat The Lamb

348

Black Hole

Unlocked a new item.

Defeat 20 portals

349

Mystery Gift

Unlocked a new item.

Destroy 500 rocks

350

Sprinkler

Unlocked a new item.

Beat chapter 1 without taking damage

351

Angry Fly

Unlocked a new item.

Become Beelzebub

352

Bozo

Unlocked a new item.

Destroy 5 rainbow poops

353

Broken Modem

Unlocked a new item.

Complete 7 daily challenges (by touching the trophy at the end)

354

Buddy in a Box

Unlocked a new item.

Pick up 5 familiars in a single run

355

Fast Bombs

Unlocked a new item.

Defeat Little Horn 20 times

356

Lil Delirium

Unlocked a new item.

Defeat Delirium for the 1st time

357

Hairpin

Unlocked a new item.

Recharge using Lil’ Batteries 20 times

358

Wooden Cross

Unlocked a new item.

Sleep in a bed

359

Butter!

Unlocked a new item.

Complete 2 Victory Laps and start a 3rd

360

Huge Growth

Unlocked a new item.

Increase in size 5 times in a single run. Sources of increased size include “One Makes you Larger” pills, XI – Strength, and Magic Mushroom

361

Ancient Recall

Unlocked a new item.

Use cards and runes 20 times

362

Era Walk

Unlocked a new item.

Have both the Broken Watch and the Stop Watch in your collection

363

Coupon

Unlocked a new item.

Purchase from Shops, Devil deals or Black Markets 50 times

364

Telekinesis

Unlocked a new item.

Beat chapter 2 without taking damage

365

Moving Box

Unlocked a new item.

Use Pandora’s Box in Dark Room

366

Jumper Cables

Unlocked a new item.

Pick up any 3 of the following items/trinkets in a single run: 9 Volt, The Battery, Car Battery, AAA Battery, Watch Battery

367

Leprosy

Unlocked a new item.

Beat chapter 3 without taking damage

368

Technology Zero

Unlocked a new item.

Pick up two technology items in one run

369

Filigree Feather

Unlocked a new item.

Acquire both key pieces

370

Mr. ME!

Unlocked a new item.

Open 20 Locked Chests

371

7 Seals

Unlocked a new item.

Defeat all 5 Harbingers

372

Angelic Prism

Unlocked a new item.

Defeat an Angel 10 times

373

Pop!

Unlocked a new item.

Beat chapter 4 without taking damage

374

Door Stop

Unlocked a new item.

Blow up doors and Secret Room walls 50 times

375

Death’s List

Unlocked a new item.

Take 25 Devil deals

376

Haemolacria

Unlocked a new item.

Acquire Blood Clot 10 times

377

Lachryphagy

Unlocked a new item.

Collect 10 “tears up” items or pills in one run

378

Schoolbag

Unlocked a new item.

Enter every Shop from chapter 1 through chapter 3 in one run

379

Trisagion

Unlocked a new item.

Take 25 items from Angel Rooms

380

Extension Cord

Unlocked a new item.

Have The Battery, 9 Volt, and Car Battery in your collection

381

Flat Stone

Unlocked a new item.

Acquire Rubber Cement 5 times

382

Sacrificial Altar

Unlocked a new item.

Take 50 Devil deals

383

Lil Spewer

Unlocked a new item.

Die to your own explosion from Ipecac, Bob’s Rotten Head, or Horf! pill

384

Blanket

Unlocked a new item.

Sleep in 10 beds

385

Marbles

Unlocked a new item.

Use 5 Gulp! pills in one run

386

Mystery Egg

Unlocked a new item.

Spawn three charmed enemies in the same room

387

Rotten Penny

Unlocked a new item.

Have 20 Blue Flies at the same time

388

Baby-Bender

Unlocked a new item.

Use I – The Magician or Telepathy for Dummies while already having homing tears

389

The Forgotten

Unlocked a new character.

It’s complicated

390

Bone Heart

Unlocked a new item.

It’s complicated

391

Marrow

Unlocked a new item.

Defeat Mom’s Heart or It Lives! on Hard mode as The Forgotten

392

Slipped Rib

Unlocked a new item.

Defeat Isaac as The Forgotten

393

Pointy Rib

Unlocked a new item.

Defeat Satan as The Forgotten

394

Jaw Bone

Unlocked a new item.

Defeat ??? as The Forgotten

395

Brittle Bones

Unlocked a new item.

Defeat The Lamb as The Forgotten

396

Divorce Papers

Unlocked a new item.

Complete the Boss Rush as The Forgotten

397

Hallowed Ground

Unlocked a new item.

Defeat Hush as The Forgotten

398

Finger Bone

Unlocked a new item.

Defeat Ultra Greed as The Forgotten

399

Dad’s Ring

Unlocked a new item.

Defeat Ultra Greedier as The Forgotten

400

Book of the Dead

Unlocked a new item.

Defeat Delirium as The Forgotten

401

Bone Baby

Unlocked a new co-player baby.

Earn all Hard mode completion marks as The Forgotten

402

Bound Baby

Unlocked a new co-player baby.

Defeat Mega Satan as The Forgotten

403

The Binding of Isaac: Rebirth Guide

Overview

Update

Activated Collectibles

Passive Collectibles

All Trinkets

Transformations

Seeds

Cards and Runes

Achievements