Isaac Cheat Sheet

The Sad Onion

ItemID: 1

"Tears up"

+0.7 Tears Up

Type: Passive

Item Pool: Item Room

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

The Inner Eye

ItemID: 2

"Triple shot"

Tears now shoot three at a time (Triple Shot)

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

Type: Passive, Tear Modifier

Item Pool: Item Room

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

Spoon Bender

ItemID: 3

"Homing shots"

Gives Isaac's tears a homing effect.

Type: Passive

Item Pool: Item Room

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

Cricket's Head

ItemID: 4

"DMG up"

+0.5 Damage Up

x1.5 times Damage Multiplier (Does not stack with the Magic Mushroom multiplier).

Can be found in golden chests.

Cricket's Head used to be known as Max's Head in the original game and was renamed for Rebirth.

Type: Passive

Item Pool: Item Room, Gold Chest

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

My Reflection

ItemID: 5

"Boomerang tears"

Gives tears a boomerang effect.

+1.5 Range Up.

+0.6 Shot Speed Up.

+1 Tear Height.

Type: Passive, Tear Modifier

Item Pool: Item Room

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

Number One

ItemID: 6

"Tears up"

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

+1.5 Tears Up.

-17.62 Range Down.

+0.76 Tear Height.

Type: Passive

Item Pool: Item Room

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

Blood of the Martyr

ItemID: 7

"DMG up"

+1.0 Damage Up.

x1.5 times Damage Multiplier if you also have Book of Belial (Does not stack with Magic Mushroom or Cricket's Head multipliers)

Type: Passive

Item Pool: Item Room

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

Brother Bobby

ItemID: 8

"Friends 'till the end"

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

Brother Bobby fires tears at a rate of 1 tear per second.

Counts as 1 of 3 familiar items needed towards the Conjoined transformation.

Type: Passive, Familiar

Item Pool: Item Room, Devil Room

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

Skatole

ItemID: 9

"Fly love"

A lot of fly enemies are no longer aggressive towards Isaac.

Attack Fly, Dart Fly, Eternal Fly, and Ring Fly are transformed into a neutral black fly.

Boom Fly, Red Boom Fly, Drowned Boom Fly move slower, but still deal contact damage.

Moter, Level 2 Fly, Full Fly, Pooter, and Super Pooter move slower and deal no contact damage.

Can only be obtained from the shell game in the arcade.

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

Type: Passive

Item Pool: None (Arcade shell game only)

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

Halo of Flies

ItemID: 10

"Projectile protection"

Gives Isaac 2 orbital flies which block enemy shots.

Picking up this item as well as 2 other fly-type items will allow you to transform into Lord of the Flies.

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

Type: Passive, Orbital

Item Pool: Item Room, Key Beggar

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

1UP

ItemID: 11

"Extra life"

Gives the player an extra life

When revived, the green mushroom that follows Isaac will disappear and he will respawn with the same amount of red heart containers at full health.

Resurrection takes place before all other items which give you an extra life

Type: Passive

Item Pool: Secret Room

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

Magic Mushroom

ItemID: 12

"All stats up!"

+1 Health Up.

+0.3 Damage Up.

x1.5 times Damage Multiplier (Does not stack with the multipliers from Cricket's Head / Blood of The Martyr + Book of Belial).

+5.25 Range Up.

+0.3 Speed Up.

+0.5 Tear Height.

Increases the size of your player sprite, but doesn't increase the hitbox.

Fully restores all red heart containers.

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

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

Type: Passive

Item Pool: Item Room, Boss Room, Mushrooms

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

The Virus

ItemID: 13

"Poison touch"

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

-0.1 Speed Down

Has a chance to drop from the Lust miniboss fight.

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

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

Type: Passive

Item Pool: Item Room, Demon Beggar, Lust Miniboss

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

Roid Rage

ItemID: 14

"Speed and range up"

+0.6 Speed Up.

+5.25 Range Up.

+0.5 Shot Height.

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

Type: Passive

Item Pool: Item Room, Boss Room, Demon Beggar

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

<3

ItemID: 15

"HP up"

+1 Health Up

Fully restores all red heart containers

Has a chance to drop from the Gluttony miniboss fight.

Type: Passive

Item Pool: Item Room, Boss Room, Gluttony Miniboss

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

Raw Liver

ItemID: 16

"HP up"

+2 Health Up.

Full red heart heal.

Type: Passive

Item Pool: Secret Room

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

Skeleton Key

ItemID: 17

"99 keys"

Gives Isaac 99 Keys

Type: Passive

Item Pool: Secret Room

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

A Dollar

ItemID: 18

"$$$"

Gives Isaac 99 coins.

Can drop from an exploding slot machine while playing it.

Type: Passive

Item Pool: None (Arcade machine only)

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

Boom!

ItemID: 19

"10 bombs"

+10 Bombs

Type: Passive

Item Pool: Item Room, Bomb Beggar

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

Transcendence

ItemID: 20

"We all float down here..."

Gives Isaac the ability to fly.

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

Type: Passive

Item Pool: Secret Room

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

The Compass

ItemID: 21

"The end is near"

Shows most icons on the map (Shops, Item Rooms, Boss Rooms etc.)

Does not show the layout of the map.

Doesn't show the location of Secret or Super Secret rooms.

Room icons will not show if a Curse of the Lost is in effect on the current floor.

Type: Passive

Item Pool: Shop, Beggar

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

Lunch

ItemID: 22

"HP up"

+1 Health Up.

Type: Passive

Item Pool: Boss Room, Challenge Room, Beggar

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

Dinner

ItemID: 23

"HP up"

+1 Health Up.

Type: Passive

Item Pool: Boss Room, Beggar, Challenge Room

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

Dessert

ItemID: 24

"HP up"

+1 Health Up.

Type: Passive

Item Pool: Boss Room, Beggar, Challenge Room

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

Breakfast

ItemID: 25

"HP up"

+1 Health Up.

Type: Passive

Item Pool: Boss Room, Challenge Room, Beggar

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

Rotten Meat

ItemID: 26

"HP up"

+1 Health Up

Type: Passive

Item Pool: Boss Room, Beggar, Challenge Room

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

Wooden Spoon

ItemID: 27

"Speed up"

+0.3 Speed Up.

Type: Passive

Item Pool: Boss Room

* boss room pool, boss room item, brown

The Belt

ItemID: 28

"Speed up"

+0.3 Speed Up.

Type: Passive

Item Pool: Boss Room

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

Mom's Underwear

ItemID: 29

"Range Up"

+5.25 Range Up

+0.5 Tear Height.

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

Type: Passive

Item Pool: Boss Room, Challenge Room

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

Mom's Heels

ItemID: 30

"Range up"

+5.25 Range Up

+0.5 Tear Height.

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

Type: Passive

Item Pool: Boss Room, Challenge Room

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

Mom's Lipstick

ItemID: 31

"Range up"

+5.25 Range Up

+0.5 Tear Height.

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

Type: Passive

Item Pool: Boss Room, Challenge Room

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

Wire Coat Hanger

ItemID: 32

"Tears up"

+0.7 Tears Up.

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

Type: Passive

Item Pool: Boss Room

* boss room pool, boss room item, black

The Bible

ItemID: 33

"Temporary flight"

Gives Isaac angel wings for the current room, allowing him to fly.

Instantly kills the Mom's Foot, Mom's Heart and It Lives boss fights.

If used during the Satan fight, The Bible will instantly kill Isaac.

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

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

Type: Active

Recharge Time: 6 rooms.

Item Pool: Shop, Library, Angel Room

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

The Book of Belial

ItemID: 34

"Temporary DMG up"

Upon use, gives +2 damage up which lasts for the current room.

x1.5 times Damage Multiplier if you also have Blood of the Martyr (Does not stack with Magic Mushroom or Cricket's Head multipliers).

Increases your chances of getting a devil/angel room by +12.5% (Before Afterbirth DLC this was a guaranteed 100%)

Judas starts with this item.

The effect stacks if used multiple times.

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

Type: Active

Recharge Time: 3 rooms

Item Pool: Library, Devil Room

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

The Necronomicon

ItemID: 35

"Mass room damage"

Deals 40 damage to everything in the room when used.

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

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

Type: Active

Recharge Time: 6 rooms

Item Pool: Library, Secret Room, Devil Room

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

The Poop

ItemID: 36

"Plop!"

Drops a poop on the floor.

Blue Baby starts with this item.

Can be placed next to a pit and exploded to make a bridge.

Can be placed over a broken red poop to overwrite it, causing it to no longer regenerate.

Counts as 1 of 3 poop items needed towards the Oh Crap transformation.

Type: Active

Recharge Time: 1 room

Item Pool: Item Room

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

Mr. Boom

ItemID: 37

"Reusable bomb buddy"

Drops a large bomb below the player which does 110 damage.

Compatible with bomb modifiers, such as Glitter Bombs, Sticky Bombs etc.

Has a chance to drop from the Wrath miniboss fight.

Type: Active

Recharge Time: 2 rooms

Item Pool: Item Room, Wrath Miniboss, Bomb Beggar

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

Tammy's Head

ItemID: 38

"Reusable tear burst"

Fires 10 tears in a circle around Isaac.

Each tear is equal to your damage stat + 25 flat damage.

The tears spawned from Tammy's Head retain tear effects of Isaac's tears, such as poison or homing.

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

Type: Active

Recharge Time: 1 room

Item Pool: Gold Chest

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

Mom's Bra

ItemID: 39

"Mass fear"

When used, freezes all enemies in the current room for about 4 seconds.

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

Type: Active

Recharge Time: 3 rooms

Item Pool: Item Room, Challenge Room

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

Kamikaze

ItemID: 40

"Become the bomb!"

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

Type: Active

Recharge Time: Instant

Item Pool: Item Room

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

Mom's Pad

ItemID: 41

"Gross..."

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

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

Type: Active

Recharge Time: 3 rooms

Item Pool: Item Room, Challenge Room

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

Bob's Rotten Head

ItemID: 42

"Reusable ranged bomb"

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

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

Synergizes with tear modifying items such as My Reflection or Tiny Planet.

Has a chance to drop from the Sloth miniboss fight.

Counts as 1 of 3 poison items needed towards the Bob transformation.

Type: Active

Recharge Time: 3 rooms

Item Pool: Item Room, Gold Chest, Sloth Miniboss

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

Teleport

ItemID: 44

"Teleport!"

Teleports Isaac to a random location on the map.

Can't be used to teleport to the I AM ERROR room.

Type: Active

Recharge Time: 2 rooms

Item Pool: Item Room

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

Yum Heart

ItemID: 45

"Reusable regeneration"

Heals Isaac for one whole red heart.

Maggy starts with this item.

When used as the Keeper, one coin HP is restored.

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

Type: Active

Recharge Time: 4 rooms

Item Pool: Item Room, Super Lust Miniboss

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

Lucky Foot

ItemID: 46

"Luck up"

+1.0 Luck Up.

Better chance to win while gambling at the Shell Game and Fortune Telling Machine.

Higher chance to get a random drop after clearing a room.

Type: Passive

Item Pool: Item Room, Beggar

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

Doctor's Remote

ItemID: 47

"Reusable air strike"

A target is placed on the floor which can be controlled. After a few seconds a huge missile hits the target and deals 20x your tear damage to anything nearby.

Essentially a one-time use of the Epic Fetus item.

Type: Active

Recharge Time: 2 rooms

Item Pool: Item Room

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

Cupid's Arrow

ItemID: 48

"Piercing shots"

Isaac's tears now have a piercing effect which allows them to travel through enemies instead of breaking on hit.

Type: Passive

Item Pool: Item Room

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

Shoop Da Whoop!

ItemID: 49

"BLLLARRRRGGG!"

When used, fires a high damage laser in a straight line across the room in a similar way to Brimstone.

The laser deals damage equal to double your tear damage. The laser hits up to 13 times if an enemy stays inside it for the duration.

Has a chance to drop from the Envy and Super Envy miniboss fights.

Type: Active

Recharge Time: 2 rooms

Item Pool: Item Room, Envy Miniboss, Super Envy Miniboss

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

Steven

ItemID: 50

"DMG up"

+1 Damage Up.

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

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

Type: Passive

Item Pool: Gold Chest, Steven Boss

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

Pentagram

ItemID: 51

"DMG up"

+1.0 Damage Up.

+10% chance of a devil/angel room opening while held.

A second Pentagram will give an extra +5% chance.

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

Type: Passive

Item Pool: Boss Room, Curse Room, Devil Room

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

Dr. Fetus

Special item

ItemID: 52

"???"

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

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

Tears Down (Tear delay * 2.5).

Bombs will also synergize with other bomb items and tear modifiers, including Sad Bombs, Mr. Mega and many more.

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

Type: Passive, Tear Modifier

Item Pool: Item Room

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

Magneto

ItemID: 53

"Item snatcher"

Causes pickups on the floor move towards the player.

Works across pits, but not through Key blocks.

Type: Passive

Item Pool: Item Room

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

Treasure Map

ItemID: 54

"Full visible map"

Reveals the entire map for every floor except the secret room locations.

Does not show the icons for any unexplored rooms.

Can still help you to guess which direction the boss room is in, due to the fact that the Boss Room is usually in the room furthest away from the first room.

Type: Passive

Item Pool: Shop, Beggar

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

Mom's Eye

ItemID: 55

"Eye in the back of your head"

Isaac has a random chance to fire another tear out the back of his head.

The chance to fire the second tear can improve based on your luck stat and will always activate at +2 Luck.

Synergizes very well with a lot of items. If used with Brimstone you have a 100% chance to fire a laser out the back of your head.

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

Type: Passive, Tear Modifier

Item Pool: Item Room, Challenge Room

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

Lemon Mishap

ItemID: 56

"Oops..."

When used, drops a pool of 'lemonade' on the floor which damages any enemies that come into contact with it for 8 damage per tick.

Type: Active

Recharge Time: 2 rooms

Item Pool: Item Room

* item room, treasure room, item room pool, yellow, chet lemon

Distant Admiration

ItemID: 57

"Attack fly"

Gives Isaac an orbiting fly which deals 5 contact damage to enemies per tick.

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

Type: Passive, Orbital

Item Pool: Item Room, Key Beggar

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

Book of Shadows

ItemID: 58

"Temporary invincibility"

Gives the player an invulnerability effect which lasts for a 10 seconds.

Can be used to get free hits on the Blood Donation machines and Devil Beggars.

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

Type: Active

Recharge Time: 3 rooms

Item Pool: Item Room, Library

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

The Ladder

ItemID: 60

"Building bridges"

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

Type: Passive

Item Pool: Shop

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

Charm of the Vampire

ItemID: 62

"Kills heal"

Heals half a heart after every 13 enemies killed.

Works with the Keeper for restoring coin HP.

Type: Passive

Item Pool: Item Room

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

The Battery

ItemID: 63

"Stores energy"

All spacebar items can now be 'overcharged', allowing them to be charged up twice instead of once.

The extra charges appear in yellow on top of the normal green bars.

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

Type: Passive

Item Pool: Shop

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

Steam Sale

ItemID: 64

"50% off"

Items in the shop are now -50% off.

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

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

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

This item is called Steamy Sale on PS4, PS Vita, Xbox One and Switch versions, probably due to copyright reasons.

Type: Passive

Item Pool: Shop, Greed Miniboss, Shopkeeper

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

Anarchist's Cookbook

ItemID: 65

"Summon bombs"

Spawns 6 troll bombs at random locations around the room.

Bombs are effected by other passive bomb items.

Has a chance to drop from the Pride miniboss fight.

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

Type: Active

Recharge Time: 3 rooms.

Item Pool: Item Room, Library, Pride Miniboss

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

The Hourglass

ItemID: 66

"Temporary enemy slowdown"

When used, slows down all enemies in the current room and their projectiles for about 8 seconds.

Type: Active

Recharge Time: 2 rooms

Item Pool: Item Room

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

Sister Maggy

ItemID: 67

"Friends 'till the end"

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

The tears appear red but have no additional damage.

Sister Maggy fires tears at a rate of 1 tear per second.

Counts as 1 of 3 familiar items needed towards the Conjoined transformation.

Type: Passive, Familiar

Item Pool: Item Room, Devil Room

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

Technology

ItemID: 68

"Laser tears"

Isaac's tears are replaced with a laser that has unlimited range and can only fire at right angles.

Lasers travel through enemies but not obstacles in the room.

Synergizes with most items that affect how many tears you fire (20/20, Mutant Spider etc.) or the path they take (My Reflection, Tiny Planet etc.).

Type: Passive, Tear Modifier

Item Pool: Item Room

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

Chocolate Milk

ItemID: 69

"Charge shots"

Isaac can now charge shots for more damage by holding down the fire button.

At full charge, your tears do 4 times more damage.

Tears fired at the minimum possible charge do roughly 1/3 of your normal damage.

You can spam the fire button to rapid fire, however the overall damage per second will be low.

Tears down: Delay * 2.5.

Type: Passive, Tear Modifier

Item Pool: Item Room

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

Growth Hormones

ItemID: 70

"DMG up + speed up"

+1.0 Damage Up

+0.4 Speed Up

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

Type: Passive

Item Pool: Boss Room, Demon Beggar

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

Mini Mush

ItemID: 71

"Speed + range up"

+0.3 Speed Up

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

Causes Isaac to shrink in size (including hitbox slightly).

Can be dropped when exploding mushrooms in the environment that are usually found in the Caves/Catacombs and in secret rooms.

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

Type: Passive

Item Pool: Item Room

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

Rosary

ItemID: 72

"Faith up"

+3 Soul Hearts.

Adds several instances of The Bible item into all item pools.

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

Type: Passive

Item Pool: Item Room, Angel Room

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

Cube of Meat

ItemID: 73

"Gotta meat em all"

An orbital which blocks shots and damages enemies it comes into contact with for 7 damage per tick.

Exclusively drops from one of the horsemen bosses.

2 cubes of meat transform the orbital into a meat head which fires blood tears which deal 3.5 damage each.

3 cubes of meat transform it into a meat boy familiar that walks around and deals 3.5 contact damage per tick to enemies.

4 cubes of meat cause the meat boy familiar to grow in size and do 5.5 damage per tick instead.

Any further cubes of meat past 4 will start the cycle again.

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

Type: Passive

Item Pool: None (Horsemen boss only)

* red, box, square

A Quarter

ItemID: 74

"+25 coins"

+25 Coins

Has a very small chance to drop after destroying one of the pots that appear in the Basement and Cellar floors.

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

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

Type: Passive

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

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

PhD

ItemID: 75

"Better pills"

Converts most negative pills into their positive counterparts, e.g. Stat Down becomes Stat Up. Bad Trip becomes Balls of Steel. Amnesia becomes I Can See Forever etc.

Pills are identified before using them.

Drops one pill on pickup.

Heals for 2 full red hearts.

Adds 0-2 coins to the payout when you use a Blood Donation machine or IV Bag.

Type: Passive

Item Pool: Item Room, Shop

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

X-Ray Vision

ItemID: 76

"I've seen everything"

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

Type: Passive

Item Pool: Item Room

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

My Little Unicorn

ItemID: 77

"Temporary badass"

Gives Isaac invincibility and +0.28 Speed for 6 seconds.

While active you cannot fire tears, but running into enemies will deal 40 contact damage per second.

Allows free hits on the Blood Donation machines and devil beggars.

Type: Active

Recharge Time: 6 rooms

Item Pool: Item Room

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

Book of Revelations

ItemID: 78

"Reusable soul protection"

Upon use, gives Isaac an extra Soul heart.

Using this item gives you a higher chance of finding a horsemen boss at the end of the floor.

+17.5% chance of a Devil Deal opening after the boss fight (Before afterbirth this was 35% chance)

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

UNLOCK: Unlock this item by beating one of the horsemen bosses for the first time.

Type: Active

Recharge Time: 6 rooms

Item Pool: Item Room, Library

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

The Mark

ItemID: 79

"DMG up"

+1.0 Damage Up.

+0.2 Speed Up.

+1 Soul Heart.

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

Type: Passive

Item Pool: Curse Room, Devil Room

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

The Pact

ItemID: 80

"DMG + tears up"

+0.5 Damage Up.

+0.7 Tears Up.

+2 Soul Hearts.

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

Type: Passive

Item Pool: Devil Room, Curse Room

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

Dead Cat

ItemID: 81

"9 lives"

Isaac's health is set to 1 and he also gains 9 extra lives.

Each time Isaac dies, he will respawn with 1 Health.

Has a chance to drop from the Super Pride mini boss.

The floating Dead Cat head that follows you will disappear when you are on your last life (Very useful for The Lost)

Counts as 1 of 3 cat items needed towards the Guppy transformation.

Type: Passive

Item Pool: Devil Room, Curse Room, Red Chest, Super Pride Miniboss

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

Lord of the Pit

ItemID: 82

"Demon wings"

Gives Isaac demon wings and the ability to fly.

+0.3 Speed Up

Type: Passive

Item Pool: Devil Room

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

The Nail

ItemID: 83

"Temporary demon form"

+0.7 Damage Up.

-0.18 Speed Down.

+1 Soul Heart

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

Allows Isaac to deal contact damage to enemies for the current room. Does not prevent Isaac from taking contact damage.

All the above effects are only active when the item is used for the current room.

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

UNLOCK: Unlock this item by beating the Boss Rush with Azazel.

Type: Active

Recharge Time: 6 rooms

Item Pool: Devil Room

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

We Need To Go Deeper

ItemID: 84

"Reusable level skip"

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

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

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

Cannot spawn a trapdoor directly infront of a secret room entrance.

Can destroy rocks if used when Isaac is flying over a rock.

Type: Active

Recharge Time: 6 rooms

Item Pool: Secret Room, Devil Room

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

Deck of Cards

ItemID: 85

"Reusable card generator"

Gives Isaac a random tarot card on use.

Type: Active

Recharge Time: 6 rooms

Item Pool: Item Room, Shop

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

Monstro's Tooth

ItemID: 86

"Summon monstro"

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

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

Type: Active

Recharge Time: 3 rooms

Item Pool: Item Room

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

Loki's Horns

ItemID: 87

"Cross tears"

Everytime you fire a tear, there is a chance that you will also fire three more tears in all cardinal directions.

The chance to fire 4-way tears is affected by your luck stat and at +7 Luck it will activate every time.

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

Type: Passive, Tear Modifier

Item Pool: Item Room

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

Little Chubby

ItemID: 88

"Attack buddy"

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

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

Type: Passive, Familiar

Item Pool: Item Room

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

Spider Bite

ItemID: 89

"Slow effect"

Tears now have a chance of slowing enemies and their projectiles for 2.5 seconds.

The chance to slow enemies is affected by your luck stat and at +15 Luck it will activate every time.

Type: Passive

Item Pool: Item Room

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

The Small Rock

ItemID: 90

"DMG up"

+1.0 Damage Up.

+0.2 Tears Up.

-0.2 Speed Down.

Has a chance to drop when exploding a tinted rock.

UNLOCK: Unlock this item by destroying 100 tinted rocks.

Type: Passive

Item Pool: None (Tinted rock only)

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

Spelunker Hat

ItemID: 91

"See-through doors"

Reveals adjacent room types, this includes revealing if you're next to a Secret Room or Super Secret Rooms.

Gives Isaac a slight glow when Curse of Darkness is active.

Type: Passive

Item Pool: Item Room

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

Super Bandage

ItemID: 92

"+2 hearts"

+1 Health Up.

+2 Soul Hearts

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

Type: Passive

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

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

The Gamekid

ItemID: 93

"Temporary Man-Pac"

When used Isaac transforms into pacman, which makes him invincible for 6 seconds and does 40 contact damage to enemies per chomp.

Everytime you 'eat' 2 enemies, you regain 1/2 heart of red health.

You can't shoot tears while the effect is active.

UNLOCK: Unlock this item by visiting 10 arcades.

Type: Active

Recharge Time: 6 rooms

Item Pool: Item Room

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

Sack of Pennies

ItemID: 94

"Gives money"

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

UNLOCK: Unlock this item by beating Isaac with Cain.

Type: Passive, Familiar

Item Pool: Item Room, Secret Room

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

Robo-Baby

ItemID: 95

"Friends till the bzzzttt"

A familiar which follows Isaac and shoots lasers, similar to the Technology item.

Robo-Baby's laser is spectral and piercing (It will pass through rocks and objects in the environment)

Robo-Baby's lasers deal 3.5 damage per hit.

Type: Passive, Familiar

Item Pool: Item Room

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

Little C.H.A.D.

ItemID: 96

"Gives kisses"

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

UNLOCK: Unlock this item by beating the Caves 30 times and defeating C.H.A.D.

Type: Passive, Familiar

Item Pool: Item Room, C.H.A.D. Boss

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

The Book of Sin

ItemID: 97

"Reusable item generator"

Spawns a random pickup on the floor.

Any pickups are possible from this item, including Bombs, hearts, keys, coins, pills, batteries, tarot cards, runes etc.

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

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

Type: Active

Recharge Time: 4 rooms

Item Pool: Item Room, Library, Devil Room

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

The Relic

ItemID: 98

"Soul generator"

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

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

Type: Passive, Familiar

Item Pool: Item Room, Angel Room

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

Little Gish

ItemID: 99

"Sticky friend"

A familiar that follows Isaac and fires black tar tears, which slow enemy movement and projectile speed for a few seconds.

Little Gish's tears do 3.5 damage.

Little Gish fires tears at a rate of 1 tear per second.

A Guaranteed drop from the Gish boss fight.

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

Type: Passive, Familiar

Item Pool: Item Room, Gish Boss

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

Little Steven

ItemID: 100

"Psychic friend"

A familiar that follows Isaac and fires homing tears that deal 3.5 damage each.

Has a high chance to drop from the Steven boss fight.

Little Steven fires tears at a rate of 1 tear per second with a slightly longer range than other familiars.

Counts as 1 of 3 familiar items needed towards the Conjoined transformation.

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

Type: Passive, Familiar

Item Pool: Item Room, Steven Boss

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

The Halo

ItemID: 101

"All stats up"

+1 Health Up.

+0.3 Damage Up.

+0.2 Tears Up.

+0.25 Range Up.

+0.3 Speed Up.

+0.5 Tear Height.

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

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

Type: Passive

Item Pool: Item Room, Boss Room, Angel Room

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

Mom's Bottle of Pills

ItemID: 102

"Reusable pill generator"

When used, gives Isaac a random pill.

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

Type: Active

Recharge Time: 6 rooms

Item Pool: Item Room, Shop, Challenge Room, Beggar, Demon Beggar

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

The Common Cold

ItemID: 103

"Poison damage"

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

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

The chance to fire poison shots is affected by your luck stat and at +12 Luck it will activate every time.

Type: Passive

Item Pool: Item Room

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

The Parasite

ItemID: 104

"Split shot"

Isaac's tears now split into two upon contact with enemies or the environment.

Tears that split off from the main tear do less damage (tear damage * 0.5).

Tears can keep splitting if they still have range and damage above 1.

UNLOCK: Unlock this item by collecting two of the following items: Bob's Rotten Head, Dead Cat, Cricket's Head, Tammy's Head.

Type: Passive

Item Pool: Item Room

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

The D6

Special item

ItemID: 105

"Reroll your destiny"

When used, replaces all pedestal items in the current room with another random item. Re-rolled items pick from the current room's item pool.

Isaac starts with this item after it is unlocked.

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

Type: Active

Recharge Time: 6 rooms

Item Pool: Item Room

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

Mr. Mega

ItemID: 106

"Blast damage"

+5 Bombs

Bombs now do 110 damage (up from 60) and have a larger blast radius.

Can be found in the secret room.

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

UNLOCK: Unlock this item by destroying 10 tinted rocks.

Type: Passive

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

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

Pinking Shears

ItemID: 107

"Cut and run"

Cuts Isaac's head from his body for the current room, allowing him to fly and leaving the decapitated body to run around attacking enemies for 5.5 damage per tick.

Type: Active

Recharge Time: 6 rooms

Item Pool: Item Room

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

The Wafer

ItemID: 108

"Damage resistance"

All damage taken is reduced to half a heart.

Damaged reduction is reduced from every source in the game except Devil Deals and health down pills.

Does not prevent death (i.e. Suicide King or using The Bible on Isaac, ??? or Satan).

The Wafer becomes most effective in the Womb and beyond where enemies all deal a whole heart of damage.

The Wafer causes the Sharp Plug item to only cost 1/2 a heart per use.

Has no effect with the Keeper - there's no such thing as half a coin health point.

Type: Passive

Item Pool: Item Room, Angel Room

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

Money = Power

ItemID: 109

"$$$ = DMG"

+0.04 Damage Up for every coin you currently have.

At 99 coins this item gives +3.96 Damage Up.

+0.04 per coin is the amount added before the damage formula is calculated, as this is the only way to show a consistent amount of damage given. You may see more or less than this on the Found HUD overlay, however this number varies based on your other damage increasing items

Type: Passive

Item Pool: Item Room

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

Mom's Contacts

ItemID: 110

"Freeze effect"

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

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

+0.25 Range Up.

+0.5 Tear Height.

Chance to activate increases with luck, up to around 50% chance at +20 luck.

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

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

Type: Passive

Item Pool: Item Room, Challenge Room

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

The Bean

ItemID: 111

"Toot on command"

Upon use, this item causes Isaac to fart and poison any enemies in close proximity.

The Bean deals 5 damage, then poisons enemies for 6 total ticks of damage.

The poison deals your current tear damage per tick. Before Afterbirth this was a flat 3.5 damage.

Type: Active

Recharge Time: 1 room.

Item Pool: Item Room, Beggar

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

Guardian Angel

ItemID: 112

"Extra protection"

An orbital which does 7 contact damage per tick, blocks shots and increases the speed of all other orbitals.

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

UNLOCK: Unlock this item by beating Satan with Maggy.

Type: Passive, Orbital

Item Pool: Angel Room

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

Demon Baby

ItemID: 113

"Auto-turret friend"

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

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

Type: Passive, Familiar

Item Pool: Item Room, Devil Room

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

Mom's Knife

Special item

ItemID: 114

"Stab stab stab"

Tears are replaced with a knife which can be charged and thrown in a boomerang style action.

The knife can also do damage without being thrown as a close range melee weapon.

When used as a melee weapon, Mom's Knife deals your tear damage * 2 per tick.

At the furthest point from Isaac the knife deals your tear damage * 6.

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

UNLOCK: Unlock this item by beating Satan with Isaac.

Type: Passive, Tear Modifier

Item Pool: Item Room, Devil Room, Challenge Room

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

Ouija Board

ItemID: 115

"Spectral tears"

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

Type: Passive

Item Pool: Item Room

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

9 Volt

ItemID: 116

"Quicker charge"

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

Fully recharges your current spacebar item when picked up.

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

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

Type: Passive

Item Pool: Shop

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

Dead Bird

ItemID: 117

"Protective buddy"

When Isaac takes damage, the dead bird will spawn and attack nearby enemies in the current room for 2 damage per tick.

Eve starts with this item.

Type: Passive, Familiar

Item Pool: Item Room

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

Brimstone

Special item

ItemID: 118

"Blood laser barrage"

Tears are replaced with the ability to charge and fire a powerful laser that travels in a straight line across the room, dealing a lot of damage (damage * 13) to any enemies it comes into contact with.

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

Synergizes very well with a lot of items including Tammy's Head, Tiny Planet, Inner Eye (Triple Shot), Mutant Spider (Quad Shot) and many others.

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

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

Type: Passive, Tear Modifier

Item Pool: Devil Room

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

Blood Bag

ItemID: 119

"HP up"

+1 Health Up

+0.3 Speed Up

Heals for 5 full red hearts.

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

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

Type: Passive

Item Pool: None (Blood Donation machine only)

* , the lost item pool, red, white

Odd Mushroom (Thin)

ItemID: 120

"Fire rate up"

Gives you a high rate of fire in exchange for a damage down.

+1.7 Tears Up.

+0.3 Speed Up.

Damage Down (damage * 0.9 - 0.4).

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

Type: Passive

Item Pool: Item Room, Secret Room, brown, purple, grey, gray

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

Odd Mushroom (Large)

ItemID: 121

"DMG up"

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

+0.3 Damage Up.

+0.25 Range Up.

-0.1 Speed Down.

+0.5 Tear Height.

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

Type: Passive

Item Pool: Item Room, Secret Room

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

Whore of Babylon

ItemID: 122

"Curse up"

When you only have half a red heart remaining or less, you enter a curse state which adds +1.5 damage and +0.3 speed.

When playing as Eve, this item activates with one FULL heart remaining or less AND also removes her 0.75 damage multiplier, raising it up to 1.0.

The effect is permanently active for characters with no red hearts (e.g. Blue Baby, The Lost).

One of Eve's starting items.

Type: Passive

Item Pool: Devil Room

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

Monster Manual

ItemID: 123

"Temporary buddy generator"

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

It can spawn familiars you haven't unlocked yet!

Type: Active

Recharge Time: 3 rooms

Item Pool: Item Room

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

Dead Sea Scrolls

ItemID: 124

"It's a mystery"

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

An item that can be found in the Angel room.

Type: Active

Recharge Time: 2 rooms

Item Pool: Item Room, Angel Room

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

Bobby - Bomb

ItemID: 125

"Friends till the end"

+5 Bombs.

All of Isaac's bombs now having a homing effect when placed on the floor.

Type: Passive

Item Pool: Item Room, Bomb Beggar

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

Razor Blade

ItemID: 126

"Feel my pain"

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

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

UNLOCK: Unlock this item by beating Satan with Eve.

Type: Active

Recharge Time: Instant

Item Pool: Devil Room

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

Forget Me Now

ItemID: 127

"I don't remember..."

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

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

Type: Active

Recharge Time: Instant (One time use)

Item Pool: Item Room, Secret Room

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

Forever Alone

ItemID: 128

"Attack fly"

An orbiting fly which deals 2 contact damage per tick to enemies.

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

Type: Passive, Orbital

Item Pool: Item Room

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

Bucket of Lard

ItemID: 129

"HP up"

+2 Health Up.

-0.2 Speed Down.

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

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

Type: Passive

Item Pool: Item Room, Super Gluttony Miniboss

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

A Pony

ItemID: 130

"Flight + dash attack"

Allows Isaac to fly while the Pony is held.

Sets your speed stat to 1.5 if it isn't already that high.

When the active attack is used, Isaac will dash across the screen dealing 40 contact damage to anything he hits.

Drops from the Headless Horseman boss fight.

Type: Active

Recharge Time: 4 rooms

Item Pool: None (Headless horseman only)

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

Bomb Bag

ItemID: 131

"Gives bombs"

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

UNLOCK: Unlock this item by beating Satan with Cain.

Type: Passive, Familiar

Item Pool: Item Room, Secret Room, Bomb Beggar

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

A Lump of Coal

ItemID: 132

"My Xmas present"

Tears gain a damage up and increase in size based on the distance they travel.

The length of a normal room roughly gives +6 damage, but this can be higher with double rooms or Tiny Planet.

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

Type: Passive

Item Pool: None (Krampus only)

* krampus, grey, gray

Guppy's Paw

ItemID: 133

"Soul converter"

When used, removes one heart container and gives you 3 soul hearts.

Bone hearts cannot be converted.

Counts as 1 of 3 cat items needed towards the Guppy transformation.

Type: Active

Recharge Time: Instant

Item Pool: Devil Room, Curse Room, Red Chest

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

Guppy's Tail

ItemID: 134

"Cursed?"

Gives a 1/3 chance for room clear rewards to become a normal or locked chest, and a 1/3 chance to reward nothing at all.

Doesn't affect coins dropped after waves in Greed Mode.

Counts as 1 of 3 cat items needed towards the Guppy transformation.

Type: Passive

Item Pool: Devil Room, Curse Room, Red Chest

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

IV Bag

ItemID: 135

"Portable blood bank"

Upon use, the IV Bag takes half a red heart and spawns 1-3 coins (the same effect as a blood donation machine)

Can drop from a blood donation machine after playing it.

In the Womb and beyond this deals 1 full heart of damage.

If no red hearts exist, other types of hearts are consumed instead.

With the Keeper this is changed to spawning 0-1 coins per use instead.

Type: Active

Recharge Time: Instant

Item Pool: None (Blood donation machine only)

* , the lost item pool, red, white

Best Friend

ItemID: 136

"Friends 'till the end"

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

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

Type: Active

Recharge Time: 3 rooms.

Item Pool: Item Room

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

Remote Detonator

ItemID: 137

"Remote bomb detonation"

+5 Bombs.

Bombs no longer automatically explode and will only do so when you activate the remote detonator.

Can be used to detonate Dr. Fetus bombs early.

Type: Active

Recharge Time: Instant

Item Pool: Item Room, Shop

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

Stigmata

ItemID: 138

"DMG + HP up"

+1 Health Up.

+0.3 Damage Up.

Type: Passive

Item Pool: Item Room

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

Mom's Purse

ItemID: 139

"More trinket room"

Isaac can now hold two trinkets at the same time

Allows you to pick up more trinkets while also holding The Tick

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

Type: Passive

Item Pool: Shop

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

Bob's Curse

ItemID: 140

"Poison bombs"

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

+5 Bombs.

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

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

Counts as 1 of 3 poison items needed towards the Bob transformation.

Type: Passive

Item Pool: Item Room, Super Sloth Miniboss, Bomb Beggar

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

Pageant Boy

ItemID: 141

"Ultimate grand supreme"

Spawns 7 random coins around Isaac on the floor.

Isaac wears a pink crown on his head.

Type: Passive

Item Pool: Boss Room

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

Scapular

ItemID: 142

"You have been blessed"

Once per room when you are damaged down to your final half a heart, you gain 1 soul heart.

Re-entering a room allows this effect to be triggered again.

Type: Passive

Item Pool: Item Room, Angel Room

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

Speed Ball

ItemID: 143

"Speed + shot speed up"

+0.3 Speed Up.

+0.2 Shot Speed Up.

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

Type: Passive

Item Pool: Item Room, Boss Room, Demon Beggar

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

Bum Friend

ItemID: 144

"He's Greedy"

A beggar who follows Isaac around and automatically picks up nearby coins.

After picking up 6 coins he will drop a random pickup, e.g. hearts, keys, bombs, coins, pills, cards, trinkets etc.

After the first drop, he has a 67% chance to drop a pickup after 3 coins and a 33% chance to drop a pickup after 4 coins.

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

Type: Passive, Familiar

Item Pool: Item Room

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

Guppy's Head

ItemID: 145

"Reusable fly hive"

When used, spawns between 2-4 blue flies.

Blue Flies do double your tear damage.

Counts as 1 of 3 cat items needed towards the Guppy transformation.

Type: Active

Recharge Time: 1 room

Item Pool: Devil Room, Curse Room, Red Chest, Gold Chest

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

Prayer Card

ItemID: 146

"Reusable eternity"

Gives Isaac an eternal heart when used.

Taking an eternal heart to the next floor or collecting two on the same floor gives you an extra heart container.

Type: Active

Recharge Time: 6 rooms

Item Pool: Item Room, Angel Room

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

Notched Axe

ItemID: 147

"Rocks didn't stand a chance"

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

Cannot break the stone blocks which appear in the environment.

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

Type: Active

Recharge Time: 3 rooms

Item Pool: Item Room

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

Infestation

ItemID: 148

"They grow inside"

When Isaac gets hit, 1-3 blue flies will randomly spawn.

Blue Flies do double your tear damage.

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

Type: Passive

Item Pool: Item Room

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

Ipecac

ItemID: 149

"Explosive shots"

Isaac's tears are replaced with explosive poison bombs, which will arc upwards and explode on contact with the floor, dealing huge damage and leaving a poison effect on enemies in range.

Ipecac shots are given a flat +40 Damage on top of the normal 3.5 base damage.

Tears Down (Tear delay * 2 + 10).

+13.0 Tear Height.

Shots will damage Isaac if he is in the blast radius when they explode.

Counts as 1 of 3 poison items needed towards the Bob transformation.

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

Type: Passive, Tear Modifier

Item Pool: Item Room

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

Tough Love

ItemID: 150

"Tooth shot"

Isaac has a random chance to fire a tooth shot instead of a tear sometimes.

Teeth shots deal damage equal to your tear damage * 3.2.

The chance to fire a tooth is affected by your luck stat and at +9 Luck it will activate every time.

Synergizes well with some tear modifiers such as Ipecac, which causes it to do massive damage.

Type: Passive

Item Pool: Item Room

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

The Mulligan

ItemID: 151

"They grow inside"

Isaac has a 1/6 chance to spawn a blue fly when one of his tears hits an enemy.

Blue Flies do double your tear damage.

The chance to activate this effect is not changed with your Luck stat.

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

Type: Passive

Item Pool: Item Room

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

Technology 2

ItemID: 152

"Laser"

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

-35% Damage Down (0.65 damage multiplier).

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

Type: Passive, Tear Modifier

Item Pool: Item Room

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

Mutant Spider

Special item

ItemID: 153

"Quad Shot"

Tears now shoot 4 at a time (Quad Shot)

Tears Down significantly (Tear delay * 2.1 + 3).

Synergizes well with a lot of tear effects - e.g. with Brimstone you get 4 lasers.

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

Type: Passive, Tear Modifier

Item Pool: Item Room

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

Chemical Peel

ItemID: 154

"DMG up"

+2 Damage Up for tears fired from Isaac's left eye.

If playing as Cain or you have an item which modifies which eye you fire tears from, each shot has a 50% chance to do +2 Damage.

Type: Passive

Item Pool: Item Room

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

The Peeper

ItemID: 155

"Plop!"

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

Type: Passive, Familiar

Item Pool: Item Room

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

Habit

ItemID: 156

"Item martyr"

When you take damage, this item recharges one room's worth of charge to your spacebar item.

For example, with the D6 you would need to take damage 6 times to fully recharge it.

Type: Passive

Item Pool: Shop, Angel Room

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

Bloody Lust

ItemID: 157

"RAGE!"

Each time you take damage, you gain a damage up which lasts for the rest of the floor and turn a darker red colour each time.

After taking 6 hits Bloody Lust doesn't give you any further damage increases.

Damage given for each hit increases as follows: +0.5, +0.5, +0.5, +33%, +33%, +33%.

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

Samson starts with this item.

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

Type: Passive

Item Pool: Item Room

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

Crystal Ball

ItemID: 158

"I see my future"

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

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

Has a chance to drop from playing a fortune machine.

Type: Active

Recharge Time: 6 rooms

Item Pool: Item Room

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

Spirit of the Night

ItemID: 159

"Scary"

Gives Isaac the ability to fly and spectral tears.

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

Type: Passive

Item Pool: Devil Room

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

Crack The Sky

ItemID: 160

"Holy white death"

Creates 5 beams of light from the sky that deal damage equal to your tear damage + 20 to any enemies which come into contact with them.

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

Type: Active

Recharge Time: 4 rooms

Item Pool: Item Room

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

Ankh

ItemID: 161

"Eternal life?"

Upon death, the player respawns as Blue Baby with three Soul hearts.

This is a one time use item and all new heart containers will be soul hearts.

Can be used to unlock some of Blue Baby's secrets before having the character available.

Type: Passive

Item Pool: Item Room

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

Celtic Cross

ItemID: 162

"You feel blessed"

Upon taking damage, you have a 20% chance to gain an invulnerability shield for 7 seconds.

The chance to gain a shield is affected by your luck stat and at +27 Luck it will activate every time.

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

Type: Passive

Item Pool: Item Room, Angel Room

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

Ghost Baby

ItemID: 163

"Spectral buddy"

A familiar which follows Isaac and shoots spectral tears that deal 3.5 damage.

Ghost Baby fires tears at a rate of 1 tear per second.

Can drop while destroying skulls in the Depths and Necropolis floors.

Type: Passive, Familiar

Item Pool: Item Room, Devil Room

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

The Candle

ItemID: 164

"Reusable flame"

A spacebar item which allows Isaac to fire a blue flame that damages anything in its path for 23 damage per tick.

Can cause up to a total of 276 potential damage.

The flame destroys enemy shots, making it useful for bullet hell bosses.

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

Type: Active

Recharge Time: Timed (A few seconds)

Item Pool: Shop

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

Cat-O-Nine-Tails

ItemID: 165

"Shot speed up + DMG up"

+1.0 Damage Up.

+0.23 Shot Speed Up.

An item only found in the Boss room pool.

Type: Passive

Item Pool: Boss Room

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

D20

ItemID: 166

"Reroll the basics"

Upon use, re-rolls all pickup consumables in the current room into another random kind of pickup.

This includes all types of pickup such as hearts, bombs, keys, coins, pills, tarot cards, chests, trinkets etc.

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

Type: Active

Recharge Time: 6 rooms

Item Pool: Item Room

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

Harlequin Baby

ItemID: 167

"Double shot buddy"

A familiar which follows Isaac and shoots two normal tears at once in a V-shaped pattern.

Each of Harlequin Baby's tears deal 4 damage.

Harlequin Baby fires tears at a rate of 1 tear per second.

Counts as 1 of 3 familiar items needed towards the Conjoined transformation.

Type: Passive, Familiar

Item Pool: Item Room

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

Epic Fetus

Special item

ItemID: 168

"On-demand air strike"

Tears now become missiles which deal huge damage to anything nearby.

Missiles damage = damage * 20.

This item places a controllable red target on the ground which will cause a missile to fall from the sky and hit it after a short period of time.

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

Type: Passive, Tear Modifier

Item Pool: Item Room

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

Polyphemus

Special item

ItemID: 169

"Mega tears"

High Damage Up - (damage + 4) * 2.

Tears Down significantly (Tear delay * 2.1 + 3).

If a tear kills an enemy, it continues to travel forward with the leftover damage.

Type: Passive

Item Pool: Item Room

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

Daddy Longlegs

ItemID: 170

"Daddy's love"

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

Type: Passive, Familiar

Item Pool: Item Room

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

Spider Butt

ItemID: 171

"Mass enemy slowdown + damage"

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

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

Type: Active

Recharge Time: 2 rooms

Item Pool: Item Room

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

Sacrificial Dagger

ItemID: 172

"My fate protects me"

Gives Isaac an orbital knife that blocks shots and deals 15 damage per tick on contact with enemies.

The highest damage orbital in the game, dealing 225 damage per second.

Synergises very well with invulnerability items such as Book of Shadows.

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

Type: Passive, Orbital

Item Pool: Item Room, Devil Room

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

Mitre

ItemID: 173

"You feel blessed"

Gives a 50% chance of converting red heart drops into soul hearts.

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

Type: Passive

Item Pool: Item Room, Angel Room

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

Rainbow Baby

ItemID: 174

"Random buddy"

A familiar the follows Isaac and fires random tears.

Rainbow Baby's tears can choose from any of the other familiars, such as homing, spectral, tar shots etc.

Type: Passive, Familiar

Item Pool: Item Room

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

Dad's Key

ItemID: 175

"Opens all doors..."

Upon use, opens all closed doors in the current room, including the ones which require a key to enter and secret room doors.

Can be used to open the golden door that appears in the Dark Room or the Chest.

Cannot be used to escape the Mom's Foot boss, open angel/devil rooms, or open the door to the Blue Womb floor.

UNLOCK: Unlock this item by collecting both Key Pieces #1 & #2 for the first time.

Type: Active

Recharge Time: 2 rooms

Item Pool: Item Room, Key Beggar

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

Stem Cells

ItemID: 176

"HP up"

+1 Health Up.

+0.16 Shot Speed Up.

Type: Passive

Item Pool: Item Room, Boss Room

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

Portable Slot

ItemID: 177

"Gamble 24/7"

Using the portable slot takes a coin and has a chance to give a pickup - similar to how the normal slot machines work.

Type: Active

Recharge Time: Instant

Item Pool: Shop, Beggar

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

Holy Water

ItemID: 178

"Splash!"

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

Type: Passive, Familiar

Item Pool: Item Room, Angel Room

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

Fate

ItemID: 179

"Flight eternal"

Gives Isaac an eternal heart and the ability to fly.

Taking an eternal heart to the next floor or collecting two on the same floor gives you an extra heart container.

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

Type: Passive

Item Pool: Gold Chest

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

The Black Bean

ItemID: 180

"Toot on touch"

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

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

Type: Passive

Item Pool: Item Room, Beggar

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

White Pony

ItemID: 181

"Flight + holy death"

Allows Isaac to fly while the White Pony is held.

While held, sets your speed stat to 1.5 if it isn't already that high. If your speed stat is already higher then that value is still used.

Upon use, Isaac charges in the direction the pony is facing, becoming invulnerable during the charge and damaging enemies while also casting the effect of Crack The Sky.

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

Drops from the Conquest boss fight.

Type: Active

Recharge Time: 6 rooms

Item Pool: None (Conquest boss only)

*, red, horse, head

Sacred Heart

Special item

ItemID: 182

"Homing shots + DMG up"

Tears are now white, do a lot more damage and move slower across the screen with a homing effect.

Health Up.

Damage Up (damage * 2.3 + 1).

-0.4 Tears Down.

-0.25 Shot Speed Down.

+4.125 Range Up.

+0.75 Tear Height.

Full red heart heal.

Type: Passive, Tear Modifier

Item Pool: Angel Room

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

Toothpicks

ItemID: 183

"Tears + shot speed up"

+0.7 Tears Up.

+0.16 Shot Speed Up.

Does not increase your damage, simply makes your tears red.

Type: Passive

Item Pool: Boss Room

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

Holy Grail

ItemID: 184

"Flight + HP up"

+1 Health Up

Gives Isaac the ability to fly.

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

Type: Passive

Item Pool: Angel Room

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

Dead Dove

ItemID: 185

"Flight + spectral tears"

Gives Isaac the ability to fly and spectral tears.

An item only found in the Angel room.

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

Type: Passive

Item Pool: Angel Room

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

Blood Rights

ItemID: 186

"Mass enemy damage at a cost"

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

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

UNLOCK: Unlock this item by beating Satan with Samson.

Type: Active

Recharge Time: Instant.

Item Pool: Item Room

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

Guppy's Hairball

ItemID: 187

"Swing it"

Follows behind Isaac and can be swung back and forth, dealing 5 contact damage per tick to anything it hits.

Every time the hairball kills an enemy, it grows in size allowing it to deal more damage.

This is one of the items which allows you to transform into Guppy.

Moving to a new floor decreases the size of the hairball.

Counts as 1 of 3 cat items needed towards the Guppy transformation.

Type: Passive, Familiar

Item Pool: Devil Room

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

Abel

ItemID: 188

"Mirrored buddy"

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

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

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

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

Type: Passive, Familiar

Item Pool: Item Room, Gold Chest

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

SMB Super Fan

ItemID: 189

"All stats up"

Isaac turns red like Meatboy.

+1 Health Up.

+0.3 Damage Up.

+0.2 Tears Up.

+0.5 Range Up.

+0.2 Speed Up.

+1.0 Tear Height.

Full red heart heal.

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

Type: Passive

Item Pool: Item Room

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

Pyro

ItemID: 190

"99 bombs"

Gives Isaac 99 bombs.

Type: Passive

Item Pool: Item Room, Secret Room, Bomb Beggar

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

3 Dollar Bill

ItemID: 191

"Rainbow tears"

Grants Isaac random tear effects.

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

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

Type: Passive, Tear Modifier

Item Pool: Item Room

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

Telepathy for Dummies

ItemID: 192

"Temporary psychic shot"

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

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

Type: Active

Recharge Time: 2 rooms

Item Pool: Item Room, Library

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

MEAT!

ItemID: 193

"DMG + HP up"

+1 Health Up.

+0.3 Damage Up.

Type: Passive

Item Pool: Boss Room

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

Magic 8 Ball

ItemID: 194

"Shot speed up"

+0.16 Shot Speed Up.

Gives Isaac a random tarot card when picked up.

Type: Passive

Item Pool: Boss Room

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

Mom's Coin Purse

ItemID: 195

"What's all this...?"

Drops 4 random pills on the floor around Isaac.

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

Type: Passive

Item Pool: Shop, Boss Room, Challenge Room, Beggar, Demon Beggar

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

Squeezy

ItemID: 196

"Tears up"

+2 Soul Hearts.

+0.4 Tears Up.

Type: Passive

Item Pool: Boss Room

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

Jesus Juice

ItemID: 197

"Damage + range up"

+0.5 Damage Up.

+0.25 Range Up.

+0.5 Tear Height.

Type: Passive

Item Pool: Boss Room

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

Box

ItemID: 198

"Stuff"

When picked up, spawns 1 red heart, 1 key, 1 bomb, 1 coin, 1 card/rune, 1 pill and 1 trinket.

Type: Passive

Item Pool: Boss Room, Challenge Room

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

Mom's Key

ItemID: 199

"Less is more now +2 keys"

+2 Keys

Doubles the yield of hearts, coins, bombs and keys that spawn from non-red chests.

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

Type: Passive

Item Pool: Shop, Challenge Room, Key Beggar

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

Mom's Eyeshadow

ItemID: 200

"Charm tears"

Tears have a random chance to charm enemies.

Charmed enemies will prioritize attacking other enemies in the room, otherwise they will still attack Isaac.

The chance to charm enemies is affected by your luck stat and at +27 Luck it will activate every time.

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

Type: Passive

Item Pool: Item Room, Challenge Room

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

Iron Bar

ItemID: 201

"Concussive tears"

+0.3 Damage Up.

Tears now have a chance to concuss enemies, causing them to walk around dazed and confused for a short period of time.

The chance to concuss enemies is affected by your luck stat and at +27 Luck it will activate every time.

Type: Passive

Item Pool: Item Room

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

Midas Touch

ItemID: 202

"Golden touch"

Isaac's touch now petrifies enemies, turning them to gold for a few seconds.

If an enemy is killed while it is golden, it will drop between 1-4 coins.

Contact damage is also dealt to enemies equal to the amount of coins Isaac is currently holding.

Has a synergy with The Poop item, which gives it a high chance to spawn golden poops.

Type: Passive

Item Pool: Item Room

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

Humbling Bundle

ItemID: 203

"1+1free 4evar!"

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

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

Type: Passive

Item Pool: Shop

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

Fanny pack

ItemID: 204

"Filled with goodies"

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

Type: Passive

Item Pool: Shop, Beggar

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

Sharp plug

ItemID: 205

"Charge with blood"

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

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

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

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

Type: Passive

Item Pool: Shop

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

The Guillotine

ItemID: 206

"An out-of-body experience"

+1.0 Damage Up.

-1 Tear Delay (Tears Up).

Causes Isaac's head to detach and orbit his body, blocking shots and dealing 7 contact damage per tick.

BFFs will cause the Guillotine head to do double damage (14 damage per tick)

Tears are still fired from Isaac's head but the hitbox remains around his body.

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

Type: Passive

Item Pool: Item Room

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

Ball of Bandages

ItemID: 207

"Gotta lick em all"

Gives Isaac an orbital ball of bandages that deals 7 contact damage per tick and blocks enemy shots.

Collecting a second Ball of Bandages in the run turns the orbital into a pink head that shoots tears that deal 7 damage each and have a chance to charm enemies.

Getting a third Ball of Bandages will transform the head into bandage girl which will chase enemies dealing 3.5 contact damage per tick while firing charm tears.

A fourth Ball of Bandages will make the Bandage Girl bigger and stronger, making her deal 5.5 damage per tick instead.

Any further Ball of Bandages will repeat the cycle.

Charmed enemies will prioritize attacking other enemies in the room, otherwise they will still attack Isaac.

Type: Passive, Orbital

Item Pool: None (Horsemen boss only)

* super meat boy, pink, plasters

Champion Belt

ItemID: 208

"DMG + Challenge up"

+1.0 Damage Up.

Increases the chance of champion enemies appearing by 15%.

Doesn't affect the chance for champion bosses to spawn.

An item only found in the Shop room pool.

Type: Passive

Item Pool: Shop

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

Butt Bombs

ItemID: 209

"Toxic blast +5 bombs"

+5 bombs.

Bombs now become poop bombs, which deal 10 damage to all enemies in the room and daze them for a short period of time.

Butt Bombs heal the poop bosses (Dingle, Dangle, Brownie) by 25% of their max HP.

Type: Passive

Item Pool: Item Room, Bomb Beggar

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

Gnawed Leaf

ItemID: 210

"Unbreakable"

If Isaac stands still and stops shooting for a second, he turns to stone, making him invincible until he moves/shoots again.

Using bombs or your active item will remove the invicibility as well.

This item is a reference to the Tanuki suit in Super Mario 3.

Type: Passive

Item Pool: Item Room

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

Spider Baby

ItemID: 211

"Spider revenge"

Spawns 1-2 friendly attack spiders every time you take damage.

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

Type: Passive

Item Pool: Item Room

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

Guppy's Collar

ItemID: 212

"Eternal life?"

When Isaac dies, he has a 50% chance to resurrect with 1/2 a heart.

Counts as 1 of 3 cat items needed towards the Guppy transformation.

Type: Passive

Item Pool: Devil Room, Curse Room, Red Chest

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

Lost Contact

ItemID: 213

"Shielded tears"

All of Isaac's tears now have a shield, allowing them to block an enemy projectile.

If a tear blocks something, both Isaac's and the enemies tears are destroyed.

If a tear blocks something, both Isaac's and the enemies tears are destroyed.

-0.16 Shot Speed Down.

Type: Passive

Item Pool: Item Room, Secret Room

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

Anemic

ItemID: 214

"Toxic blood"

+5 Range Up.

When Isaac takes damage, he will start to leave a trail of blood creep behind him as he walks for the current room. The creep deals 2 damage per tick while enemies stand in it.

Lazarus' revived form (Lazarus II) respawns with this item.

Type: Passive

Item Pool: Item Room

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

Goat Head

ItemID: 215

"He accepts your offering"

Gives Isaac a guaranteed devil or angel room on every floor that they can appear, even if you have already beaten the boss and it didn't show up originally.

Taking the Goat Head (or any other item) in a Devil Deal bars you from encountering Angel Rooms naturally. After which, the only way to access an Angel Room is via the Sacrifice Room.

Type: Passive

Item Pool: Devil Room, Curse Room, Red Chest, Golden Chest

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

Ceremonial Robes

ItemID: 216

"Sin up"

+3 Black Hearts.

+1 Damage Up.

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

Type: Passive

Item Pool: Devil Room, Curse Room, Demon Beggar

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

Mom's Wig

ItemID: 217

"You feel itchy"

Isaac now has a small chance to create friendly attack spiders everytime he fires a tear.

Can create up to a maximum of 5 spiders in the room at one time.

The Hive Mind item allows Mom's Wig to spawn a maximum of 10 spiders at once, and increases their damage.

The chance to create a spider is affected by your luck stat and at +10 Luck it will activate every time.

Heals you for 1 red heart when picked up.

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

Type: Passive

Item Pool: Item Room, Challenge Room

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

Placenta

ItemID: 218

"HP up + regen"

+1 Health Up.

Gives a chance to heal 1/2 a red heart every time the in-game timer hits a new minute.

There are no restrictions on when the regeneration effect happens as long as the game is not paused, so you can simply afk and heal over time.

Works in crawl spaces.

It's possible to find this item by blowing up Polyps (the weird red rocks found in the Womb floors)

Type: Passive

Item Pool: Boss Room

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

Old Bandage

ItemID: 219

"HP up"

+1 Health Up.

The given heart container is empty.

When you get hit, you will sometimes cause hearts to drop on the floor.

The chance to drop hearts is affected by your luck stat and at +29 Luck it will activate 50% of the time.

Type: Passive

Item Pool: Boss Room

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

Sad Bombs

ItemID: 220

"Tear blast +5 bombs"

+5 Bombs

Everytime a bomb explodes, it will release a circle of 10 tears outwards, much like the Tammy's Head effect.

The tears from each bomb deal a flat 25 damage and are affected by any tear modifiers Isaac has.

The tears caused by Sad Bombs are much larger and do a lot more damage than Isaac's normal tears.

Type: Passive

Item Pool: Item Room, Bomb Beggar

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

Rubber Cement

ItemID: 221

"Bouncing tears"

Isaac's tears now bounce off walls and objects in the environment, such as rocks and pots.

Allows tears to hit the same enemy multiple times.

If you also have Lost Contact, tears will bounce off enemy projectiles instead of being destroyed.

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

Type: Passive

Item Pool: Item Room, Greed Mode Item Room

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

Anti-Gravity

ItemID: 222

"Antigravity tears + tears up"

-2 Tear Delay (Tears Up).

As you hold down the fire button, shots will float in the same place until you release the fire key again.

Allows you to store up a lot of tears in the air and release them all at once.

When the tears are released, they will fire off in the direction that Isaac was originally facing when it was created.

Type: Passive, Tear Modifier

Item Pool: Item Room

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

Pyromaniac

Special item

ItemID: 223

"Hurts so good +5 bombs"

+5 Bombs

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

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

Type: Passive

Item Pool: Item Room

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

Cricket's Body

ItemID: 224

"Splash damage + tears up"

-1 Tear Delay (Tears Up).

-10.0 Range Down.

x1.2 Tear Size.

Makes tears break into 4 smaller tears on impact with anything, which deal half of your damage.

Type: Passive

Item Pool: Item Room

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

Gimpy

ItemID: 225

"Sweet suffering"

When getting hit, this item has a chance to drop a soul heart or black heart.

The chance to spawn a heart is affected by your luck stat and at +22 Luck it will activate 50% of the time.

Enemies have a chance to drop half a red heart when killed.

Type: Passive

Item Pool: Item Room, Devil Room, Curse Room, Demon Beggar

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

Black Lotus

ItemID: 226

"HP up x3"

+1 Health Up.

+1 Soul Heart.

+1 Black Heart.

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

An item only found in the secret room pool.

Type: Passive

Item Pool: Secret Room

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

Piggy Bank

ItemID: 227

"My life savings"

+3 Coins when picked up.

When you take damage, 1-2 coins will drop on the floor.

When playing as the Keeper, this item drops 0-1 coins instead.

Type: Passive

Item Pool: Item Room, Shop

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

Mom's Perfume:

ItemID: 228

"Fear shot"

-1 Tear Delay (Tears Up).

Isaac's tears have a 15% chance of causing a fear effect.

Feared enemies will run away from Isaac temporarily.

The chance to fear enemies is affected by your luck stat and at +85 Luck it will activate every time.

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

Type: Passive

Item Pool: Item Room, Challenge Room

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

Monstro's Lung

ItemID: 229

"Charged attack"

Tears can now be charged and released in a shotgun style effect, much like Monstro's main attack.

Tears down (Tear delay * 4.3).

Partial charging does nothing - must be fully charged to use.

Type: Passive, Tear Modifier

Item Pool: Item Room

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

Abaddon

ItemID: 230

"Evil up + DMG up + fear shot"

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

+1.5 Damage Up.

+0.2 Speed Up.

Tears now have a chance to induce the fear effect, causing enemies to run away from Isaac for a short period.

The chance to fear enemies is affected by your luck stat and at +85 Luck it will activate every time.

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

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

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

Type: Passive

Item Pool: Devil Room

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

Ball of Tar

ItemID: 231

"Sticky feet..."

Isaac leaves a trail of tar behind him which will slow down enemies that walk over it.

Tears have a chance to slow enemies and their projectiles for a short period of time.

The chance to slow enemies can improve based on your luck stat and will always slow enemies at +18 Luck.

Type: Passive

Item Pool: Item Room

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

Stop Watch

ItemID: 232

"Let's slow this down a bit"

+0.3 Speed Up.

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

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

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

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

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

Type: Passive

Item Pool: Shop

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

Tiny Planet

ItemID: 233

"Orbiting tears + range up"

+7.0 Tear Height.

Range greatly increased.

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

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

Causes a lot of great synergies with items such as Lump of Coal, Brimstone, Rubber Cement, Technology and most of the worm trinkets.

Type: Passive, Tear Modifier

Item Pool: Item Room

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

Infestation 2

ItemID: 234

"Infestation shot"

Creates a friendly blue spider when you kill an enemy.

Spiders are spawned at the location where the enemy died.

Type: Passive

Item Pool: Item Room

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

E. Coli

ItemID: 236

"Turdy Touch"

E. Coli turns normal enemies into poop if they touch you.

Enemies can turn into poop even if they do not do contact damage, allowing you to apply the effect without taking damage.

Can be combined with Midas Touch to turn enemies into Golden Poop.

This does not work on mini-bosses and bosses.

Counts as 1 of 3 poop items needed towards the Oh Crap transformation.

Type: Passive

Item Pool: Item Room

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

Death's Touch

ItemID: 237

"Penetrative shots + DMG up"

+1.5 Damage Up.

-0.3 Tears Down.

x2 Tear Size.

Isaac's tears turn into large scythes that pierce through enemies (Similar to how Death's scythes look).

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

Type: Passive, Tear Modifier

Item Pool: Item Room, Devil Room

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

Key Piece #1

ItemID: 238

"???"

Increases your chances to find an Angel Room instead of a Devil Room. See the dedicated Devil room page for more details.

First half of the key required to enter the door to the Mega Satan boss.

Drops from one of the angels which appear by bombing the statue in an angel room.

Type: Passive, Familiar

Item Pool: None (Angel statue only)

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

Key Piece #2

ItemID: 239

"???"

Increases your chances to find an Angel Room instead of a Devil Room. See the dedicated Devil room page for more details.

Second half of the key required to enter the door to the Mega Satan boss.

Drops from one of the angels which appear by bombing the statue in an angel room.

Type: Passive, Familiar

Item Pool: None (Angel statue only)

*, yellow, gold, broken

Experimental Treatment

ItemID: 240

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

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

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

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

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

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

Type: Passive

Item Pool: Item Room, Boss Room, Demon Beggar

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

Contract From Below

ItemID: 241

"Wealth, but at what cost?"

Doubles pickups and chests from clearing a room.

Also gives a 30% chance for room clear rewards to not spawn.

Doesn't affect coins spawned in Greed Mode.

Type: Passive

Item Pool: Devil Room, Curse Room, Demon Beggar

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

Infamy

ItemID: 242

"Blocks damage... sometimes"

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

Type: Passive

Item Pool: Item Room, Gold Chest, Secret Room

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

Trinity Shield

ItemID: 243

"You feel guarded"

Puts a shield in front of Isaac which blocks projectiles.

The shield will rotate based on the direction in which Isaac is firing tears.

Type: Passive

Item Pool: Angel Room

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

Tech.5

ItemID: 244

"It's still being tested"

Gives Isaac a laser that will fire at random intervals in addition to your normal tears.

Each laser does damage equal to your current tear damage.

The laser will occasionally fire with one of these effects: Hook Worm, Spoon Bender, Tiny Planet, Mysterious Liquid, Rubber Cement.

Luck has no effect on the rate at which Tech.5 fires and does not scale with items that increase your tears stat.

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

Type: Passive, Tear Modifier

Item Pool: Item Room

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

20/20

ItemID: 245

"Double shot"

Isaac now shoots two tears at once.

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

Type: Passive, Tear Modifier

Item Pool: Item Room

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

Blue Map

ItemID: 246

"Secrets"

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

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

Type: Passive

Item Pool: Shop, Beggar, Key Beggar

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

BFFS!

ItemID: 247

"Your friends rule!"

Makes all of Isaac's familiars stronger and bigger.

Causes most familiars to deal double damage.

Has no effect on most familiars that scale with Isaac's tear damage.

Type: Passive

Item Pool: Shop, Key Beggar

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

Hive Mind

ItemID: 248

"Giant spiders and flies"

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

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

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

Type: Passive

Item Pool: Shop

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

There's Options

ItemID: 249

"More options"

Two items now spawn after beating a boss fight and the boss rush, however only one can be taken.

The additional item will pick from the Boss Item Pool.

Does nothing after the Krampus fight.

Unlocked by donating to the donation machine in the shop.

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

Type: Passive

Item Pool: Shop

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

Bogo Bombs

ItemID: 250

"1+1 bombs"

All bomb pickups are now 1+1 bombs.

An item only found in the Shop item pool.

Type: Passive

Item Pool: Shop, Bomb Beggar

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

Starter Deck

ItemID: 251

"Extra card room"

Spawns a random card.

Isaac can now hold 2 cards or runes at once. Tap the drop button to cycle between each one

All future pill drops will now instead become cards.

An item only available in the Shop room.

Type: Passive

Item Pool: Shop

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

Little Baggy

ItemID: 252

"Extra pill room"

Allows for 2 pills to be held. Tap the drop button to cycle between each one

Drops a pill on the floor when picked up.

Changes all card and rune drops into pills. Any Tarot card or rune on the floor or current held when picking this item up will change into a pill.

Dice Shard counts as a card and will be converted.

UNLOCK: Unlock this item by picking up 2 of the following items: Roid Rage, The Virus, Growth Hormones, Experimental Treatment or Speed Ball.

Type: Passive

Item Pool: Shop

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

Magic Scab

ItemID: 253

"HP + luck up"

+1 Health Up.

+1.0 Luck Up.

Type: Passive

Item Pool: Boss Room

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

Blood Clot

ItemID: 254

"DMG + range up"

+1.0 Damage Up (Left eye only).

+5 Range Up (Left eye only).

The above stats only apply to tears fired from Isaac's left eye or with a 50% chance if you have an item which causes you to fire from a single source only.

Type: Passive

Item Pool: Boss Room

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

Screw

ItemID: 255

"Tears + shot speed up"

+0.5 Tears Up

+0.2 Shot Speed Up

Type: Passive

Item Pool: Boss Room

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

Hot Bombs

ItemID: 256

"Burning blast +5 bombs"

+5 Bombs

Gives all bombs a burning effect when they explode, leaving fire on the floor which deals 22 damage to enemies.

Type: Passive

Item Pool: Item Room, Bomb Beggar

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

Fire Mind

ItemID: 257

"Flaming tears"

Isaac's tears now set enemies on fire, leaving a damage over time effect that does 4 or 6 damage per tick.

There is a chance that tears that hit enemies will explode, leaving a small fire on the floor that damages enemies.

Exploding tears deal damage * 2 + 22 per tick.

The chance for tears to explode is affected by your luck stat and at +13 Luck it will activate every time.

Type: Passive

Item Pool: Item Room

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

Missing No.

ItemID: 258

"Syntax error"

When picked up, and at the start of each floor this rerolls all your current items, giving you a new item to replace each of the ones you had.

Also rerolls all your stats at the same time, giving a random flat modifier that changes each time.

Doesn't affect important items such as Polaroid, Negative and Key Pieces.

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

Type: Passive

Item Pool: Secret Room

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

Dark Matter

ItemID: 259

"Fear shot"

+1.0 Damage Up.

Tears now have a chance to apply the fear effect to enemies, which causes them to run away from Isaac.

The chance to fear enemies is affected by your luck stat and at +20 Luck it will activate every time.

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

Type: Passive

Item Pool: Devil Room

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

Black Candle

ItemID: 260

"Curse of immunity + evil up"

+1 Black Heart.

Immunity to all floor curses (e.g. Curse of the Lost)

Black Candle removes the teleportation effect of Cursed Eye.

+15% chance of a devil or angel room opening after the boss fight.

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

Type: Passive

Item Pool: Shop, Curse Room

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

Proptosis

ItemID: 261

"Short range mega tears"

Gives Isaac high damage tears with a short range.

Tear size and damage falls off very fast with this item, the further the tear travels the less damage it does.

Tear damage starts at double (+100%) and decreases over range to roughly (+30%).

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

Type: Passive, Tear Modifier

Item Pool: Item Room

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

Missing Page 2

ItemID: 262

"Evil up + your enemies will pay"

+1 Black Heart.

If the total sum of all your health is at one heart after taking damage, the necronomicon effect will activate, dealing 40 damage to the entire room.

Type: Passive

Item Pool: Devil Room, Demon Beggar, Secret Room

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

Smart Fly

ItemID: 264

"Revenge fly"

A yellow orbital fly that will block shots and when Isaac gets hit, will seek out the nearest enemy and attack it.

If the fly is in its attacking state and there are no longer any enemies in range, it will return to Isaac and go back to being a defensive orbital.

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

Type: Passive, Familiar

Item Pool: Item Room, Key Beggar

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

Dry Baby

ItemID: 265

"Immortal friend"

A familiar that follows Isaac and blocks any shots that hit it.

If a projectile is blocked by Dry Baby, he has a 10% chance to activate the Necronomicon effect, dealing 40 damage to the entire room.

The chance to activate the effect is not changed by your Luck stat.

Can drop while destroying skulls in the Depths and Necropolis floors.

Type: Passive, Familiar

Item Pool: Item Room

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

Juicy Sack

ItemID: 266

"Sticky babies"

A familiar that follows isaac around dropping white creep which slows down enemies that walk over it.

Spawns 1-2 familiar blue spiders after every room.

Blue Spiders do 2.5x of Isaac's damage.

Type: Passive, Familiar

Item Pool: Item Room

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

Robo-Baby 2.0

ItemID: 267

"We worked out all the kinks"

A familiar that is controlled via the arrow keys and will automatically fire a laser if anything is in its line of sight.

Robo-Baby 2.0's lasers deal 3.5 damage per hit.

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

Type: Passive, Familiar

Item Pool: Item Room

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

Rotten Baby

ItemID: 268

"Infested friend"

A familiar which follows Isaac and spawns a blue flies as you're firing tears.

Rotten Baby can only create one fly at a time, meaning if he has created a fly he cannot make another until it is used.

Blue Flies do double your tear damage.

Counts as 1 of 3 familiar items needed towards the Conjoined transformation.

Type: Passive, Familiar

Item Pool: Item Room, Devil Room

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

Headless Baby

ItemID: 269

"Bloody friend"

A familiar that follows Isaac and leaves blood creep on the floor as it floats, hurting enemies that walk over it for 2 damage per tick.

Counts as 1 of 3 familiar items needed towards the Conjoined transformation.

Type: Passive, Familiar

Item Pool: Item Room, Devil Room

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

Leech

ItemID: 270

"Blood sucker"

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

The Leech deals 1.5 contact damage per tick.

Type: Passive, Familiar

Item Pool: Item Room

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

Mystery Sack

ItemID: 271

"?"

A bag that follows Isaac and drops a random heart, coin, bomb or key every 5-6 rooms (alternating, 5 rooms then 6, then repeats).

Can drop any kind of heart, coin, bomb or key.

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

Type: Passive, Familiar

Item Pool: Item Room, Beggar, Secret Room

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

BBF

ItemID: 272

"Big beautiful fly"

A large familiar black fly that bounces around the room, exploding on contact with enemies dealing 70 damage.

Does not explode if it hits Isaac, however if it explodes on an enemy while Isaac is in range, he will take damage.

Respawns after 10 seconds or by moving to another room.

Picking up this item as well as 2 other fly-type items will allow you to transform into Lord of the Flies.

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

Type: Passive, Familiar

Item Pool: Item Room

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

Bob's Brain

ItemID: 273

"Explosive thoughts"

A green brain that launches in the direction you are firing your tears and will explode on contact with enemies, dealing damage and poisoning anything in the blast radius.

Bob's Brain deals 60 damage and applies a poison damage over time effect, which deals double your tear damage per tick.

Regenerates over time.

Will hurt Isaac if he is in the blast radius.

Counts as 1 of 3 poison items needed towards the Bob transformation.

Type: Passive, Familiar

Item Pool: Item Room, Gold Chest

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

Best Bud

ItemID: 274

"Sworn protector"

When Isaac takes damage, a white attack fly will spawn that orbits him at a similar distance to the Distant Admiration fly.

The fly orbits a lot faster than Distant Admiration or Forever Alone and deals 5 damage per tick.

Picking up this item as well as 2 other fly-type items will allow you to transform into Lord of the Flies.

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

Type: Passive, Orbital

Item Pool: Item Room, Key Beggar

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

Lil Brimstone

ItemID: 275

"Evil friend"

A familiar that follows Isaac and can fire up and charge brimstone shots, exactly how the normal Brimstone item works but with less damage.

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

A familiar found in the devil room.

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

Type: Passive, Familiar

Item Pool: Item Room, Devil Room

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

Isaac's Heart

ItemID: 276

"Protect it"

Prevents Isaac from taking any damage, but instead summons a familiar heart that follows you around. If the heart is hit, Isaac will take damage.

Most enemies will target the heart over Isaac himself.

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

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

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

Type: Passive, Familiar

Item Pool: Item Room

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

Lil Haunt

ItemID: 277

"Fear him"

A familiar ghost that follows Isaac around and chases enemies close-by, damaging them for 2 contact damage and causing a fear effect.

Type: Passive, Familiar

Item Pool: Item Room

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

Dark Bum

ItemID: 278

"He wants to take your life"

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

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

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

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

Type: Passive, Familiar

Item Pool: Item Room, Devil Room

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

Big Fan

ItemID: 279

"Fat protector"

A very large orbital that moves around Isaac very slowly, blocking shots and dealing 2 contact damage per tick.

Affects the speed of all other orbitals, slowing them down a lot (NOTE: This effect does not happen until you get a new orbital after Big Fan).

Does not count as one of your three standard orbital slots.

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

Type: Passive, Orbital

Item Pool: Item Room

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

Sissy Long Legs

ItemID: 280

"She loves you"

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

Blue Spiders do 2.5x of Isaac's damage.

She can only spawn a maximum of up to 5 spiders at a time and will only do so while there are enemies in the room.

Type: Passive, Familiar

Item Pool: Item Room

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

Punching Bag

ItemID: 281

"Scape goat"

Spawns a friendly Mulligan that walks around the room. Mulligan can be hit by enemy projectiles, making him a good shield.

Enemies will sometimes target the Mulligan if he is closer.

Type: Passive, Familiar

Item Pool: Item Room

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

How To Jump

ItemID: 282

"It's time you learned how"

When used, makes Isaac leap in the air, similar to the leaper enemies.

Maintains momentum if you are already moving in the same direction.

If you already have an item which gives you flying, this item becomes a dash effect instead.

Can be used in the Isaac boss fight to jump over the beams of light he spawns.

Type: Active

Recharge Time: Instant

Item Pool: Item Room, Library

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

D100

Special item

ItemID: 283

"REEROLLLLL!"

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

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

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

Type: Active

Recharge Time: 6 rooms

Item Pool: Item Room

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

D4

ItemID: 284

"Reroll into something else"

When used, the D4 re-rolls each item you currently have into another random item from the same item pool.

If you have an item with no room pool (e.g. Blood Bag) it will be rerolled into a random Item Room item.

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

Cannot remove Azazel's Brimstone laser.

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

Type: Active

Recharge Time: 6 rooms

Item Pool: Item Room

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

D10

ItemID: 285

"Rerolls enemies"

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

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

Cannot reroll mini-bosses or bosses.

Type: Active

Recharge Time: 1 room

Item Pool: Item Room

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

Blank Card

ItemID: 286

"Card Mimic"

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

Doesn't work with pills.

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

An item that often appears in the shop.

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

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

Type: Active

Recharge Time: 4 rooms.

Item Pool: Item Room, Shop, Secret Room

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

Book of Secrets

ItemID: 287

"??????"

When used, you have a chance of getting one of the three following effects: Treasure Map (floor layout), Compass (map icons) or Blue Map (secret room locations)

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

UNLOCK: Unlock this item by beating Satan with Eden.

Type: Active

Recharge Time: 6 rooms

Item Pool: Item Room, Library, Secret Room

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

Box of Spiders

ItemID: 288

"It's a box of spiders"

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

Blue Spiders do 2.5x of Isaac's damage.

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

Type: Active

Recharge Time: 2 rooms

Item Pool: Item Room

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

Red Candle

ItemID: 289

"Flame on"

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

Each flame deals 125 total damagebefore it disappears.

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

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

Type: Active

Recharge Time: Timed (A few seconds)

Item Pool: Shop

* shop room pool, shop item pool

The Jar

ItemID: 290

"Save your life"

Isaac can now pick up hearts while at full health, which will be stored in the Jar and can be spawned again using the spacebar.

Up to 4 hearts can be stored in The Jar.

Soul hearts and black hearts cannot be stored.

If used in a Black heart or Eternal heart super secret room, it will spawn the relevant heart.

Type: Active

Recharge Time: Instant

Item Pool: Shop

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

FLUSH!

ItemID: 291

"..."

When used, turns every normal enemy in the room into poop!

Does not work on mini-bosses and bosses.

Kills poop bosses when used - Dingle, Dangle and Brownie.

Counts as 1 of 3 poop items needed towards the Oh Crap transformation.

Type: Active

Recharge Time: 6 rooms

Item Pool: Item Room

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

The Satanic Bible

ItemID: 292

"Reusable evil"

When used, gives Isaac +1 Black Heart.

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

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

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

Type: Active

Recharge Time: 6 rooms

Item Pool: Item Room, Library, Devil Room

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

Head of Krampus

ItemID: 293

"Krampus rage"

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

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

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

Laser damage does not scale with your damage stat.

Has a chance to drop after you beat Krampus.

If you get close enough to an enemy that has a large hitbox, you can hit it with 2 of the laser beams, allowing you to deal a lot more damage.

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

Type: Active

Recharge Time: 6 rooms

Item Pool: None (Krampus only)

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

Butter Bean

ItemID: 294

"Reusable knockback"

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

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

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

UNLOCK: Unlock this item by destroying 100 poops.

Type: Active

Recharge Time: Timed (A few seconds)

Item Pool: Item Room, Beggar

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

Magic Fingers

ItemID: 295

"Pay to play"

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

Damage dealt is equal to your tear damage * 2.

Type: Active

Recharge Time: Instant

Item Pool: Item Room, Shop

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

Converter

ItemID: 296

"Convert your soul"

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

This item will take from your soul hearts first.

Type: Active

Recharge Time: Instant

Item Pool: Shop

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

Unicorn Stump

ItemID: 298

"You feel stumped"

When used, turns Isaac invincible and gains +0.28 speed for a 5 seconds.

You cannot fire tears while the stump is active.

Very similar to the My Little Unicorn item but does not deal contact damage.

When used with Mom's Knife, you can still deal contact damage but will be unable to change the way the knife faces while the effect is active.

Type: Active

Recharge Time: 1 room

Item Pool: Item Room

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

Taurus

ItemID: 299

"Speed down + rage is building"

-0.3 Speed Down.

While in a hostile room your speed raises at a rate of +0.065 per game tick.

When you hit a speed stat of 2.0, Isaac will gain an invincibility effect for 5 seconds, increasing speed and allowing him to run into enemies to deal 40 contact damage per hit.

The time it takes for the effect to activate becomes shorter with a higher base Speed stat.

One of the twelve zodiac items available in the game.

Type: Passive

Item Pool: Item Room

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

Aries

ItemID: 300

"Ramming speed"

+0.25 Speed up.

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

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

One of the twelve zodiac items available in the game.

Type: Passive

Item Pool: Item Room

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

Cancer

ItemID: 301

"HP up + you feel protected"

+3 Soul Hearts

After getting hit once, you gain a damage reduction for the rest of the room similar to The Wafer item (-50% damage taken).

One of the twelve zodiac items available in the game.

Type: Passive

Item Pool: Item Room

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

Leo

ItemID: 302

"Stompy"

Isaac increases in size, gets a lion's mane and now has the ability to crush rocks by walking over them.

Crushed rocks and poop can fill holes if you walk in their direction.

Allows you to crush Red Poops and sometimes not take damage. However, If you also have flying you will always take damage.

One of the twelve zodiac items available in the game.

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

Type: Passive

Item Pool: Item Room

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

Virgo

ItemID: 303

"You feel refreshed and protected"

A random chance when you take damage to get an invincibility shield for 7 seconds.

The chance to get an invincibility shield is affected by your luck stat and at +10 Luck it will activate every time you get hit.

Converts all negative pills into their positive counterparts e.g. Stat Down becomes Stat Up, 'Bad Trip' turns into 'Balls of Steel' and 'Amnesia' turns into 'I can see forever'.

One of the twelve zodiac items available in the game.

Type: Passive

Item Pool: Item Room

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

Libra

ItemID: 304

"You feel balanced"

Gives you 6 keys, 6 bombs and 6 coins.

Balances out your main stats to bring the high and low stats closer to an average value.

All future stat upgrading items will now instead spread out across all other stats. For example, an item which usually gives +1 Damage would instead give a small 'all stats up'.

Stats effected by this item are: Damage, Tears, Range, Speed.

When taken with another item which gives an extreme value in a certain stat (e.g. Soy Milk) can lead to interesting synergies.

One of the twelve zodiac items available in the game.

Type: Passive

Item Pool: Item Room

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

Scorpio

ItemID: 305

"Poison tears"

Isaac's tears turn bright green and always apply a poison effect to enemies which deals a total of double your tear damage.

This is essentially a superior version of The Common Cold item.

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

One of the twelve zodiac items available in the game.

Type: Passive

Item Pool: Item Room

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

Sagittarius

ItemID: 306

"Penetrative shot + speed up"

+0.2 Speed Up.

Grants piercing tears.

Tears do not travel through rocks with this item.

One of the twelve zodiac items available in the game.

Type: Passive

Item Pool: Item Room

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

Capricorn

ItemID: 307

"All stats up"

+1 Health Up.

+0.5 Damage Up.

-1 Tear Delay (Tears Up).

+0.1 Speed Up.

+1.5 Range Up.

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

One of the twelve zodiac items available in the game.

Type: Passive

Item Pool: Item Room

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

Aquarius

ItemID: 308

"A trail of tears"

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

One of the twelve zodiac items available in the game.

Type: Passive

Item Pool: Item Room

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

Pisces

ItemID: 309

"Tears up + knockback shot"

-1 Tear Delay (Tears Up).

x1.25 Tear Size Up.

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

One of the twelve zodiac items available in the game.

Type: Passive

Item Pool: Item Room

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

Eve's Mascara

ItemID: 310

"Shot speed down + DMG up"

x2 Damage Multiplier.

Tears Down by exactly half (Tear delay * 2)

-0.5 Shot Speed Down.

The tears down from this item is a x2.0 multiplier after the formula, meaning it will always halve your tear rate (Unless you have Monstro's Lung or Soy Milk).

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

Type: Passive

Item Pool: Item Room

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

Judas' Shadow

ItemID: 311

"Sweet revenge"

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

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

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

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

Type: Passive

Item Pool: Item Room, Devil Room

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

Maggy's Bow

ItemID: 312

"HP up + you feel healthy"

+1 Health Up.

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

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

Type: Passive

Item Pool: Item Room

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

Holy Mantle

ItemID: 313

"Holy shield"

Each time you enter a new room, damage is negated for the first time you get hit.

Can be used to go in and out of a Curse Room without taking damage.

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

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

Type: Passive

Item Pool: Item Room, Angel Room

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

Thunder Thighs

ItemID: 314

"HP + speed down + you feel strong"

+1 Health Up.

-0.4 Speed Down.

You can now break obstacles by walking over them.

Holes in the ground can be filled by crushing adjacent rocks, similar to how this can be done with bombs.

Allows you to crush Red Poops and sometimes not take damage. However, If you also have flying you will always take damage.

Type: Passive

Item Pool: Item Room

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

Strange Attractor

ItemID: 315

"Magnetic tears"

Enemies and pickups (keys, bombs etc.) are now magnetically attracted to Isaac's tears.

Can cause some enemies to have unpredictable movement.

Type: Passive

Item Pool: Item Room

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

Cursed Eye

ItemID: 316

"Cursed charged shot"

Tears are now charged up and fired rapidly in a burst of up to 4 shots at once.

The amount of tears fired in the charge depends on how long you charge for.

The eye has three states, white (not firing), black (first second of charging) and blinking between black and white. If you get hit while Cursed eye is a solid black colour you are guaranteed to be teleported to another random room on the floor. If you get hit in either of the other 2 states you will not be teleported.

The Black Candle item will remove the Cursed Eye's teleportation effect

Type: Passive, Tear Modifier

Item Pool: Item Room, Secret Room

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

Mysterious Liquid

ItemID: 317

"Toxic splash damage"

When Isaac's tears hit anything, they leave a green toxic creep on the floor that damages enemies for 1 damage per tick.

Type: Passive

Item Pool: Item Room

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

Gemini

ItemID: 318

"Conjoined friend"

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

One of the twelve zodiac items available in the game.

Type: Passive, Familiar

Item Pool: Item Room

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

Cain's Other Eye

ItemID: 319

"Near sighted friend"

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

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

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

Type: Passive, Familiar

Item Pool: Item Room

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

???'s Only Friend

ItemID: 320

"Controlled friend"

A familiar fly that can be moved around via use of the arrow keys dealing 2.5 contact damage per tick, similar to the Ludovico Technique's mechanic.

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

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

Type: Passive, Familiar

Item Pool: Item Room

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

Samson's Chains

ItemID: 321

"The ol' ball and chain"

An iron ball and chain attached to Isaac, similar to Guppy's Hairball that you can fling around to deal 5 damage per tick.

The ball will block enemy shots and can also destroy environmental objects such as rocks, mushrooms and skulls.

Does not decrease your movement speed stat at all however the ball has to be dragged around causing Isaac to slow down slightly when the chain is fully extended.

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

Type: Passive, Familiar

Item Pool: Item Room, Secret Room

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

Mongo Baby

ItemID: 322

"Mongo friend"

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

Deals double the damage as normal familiars.

If you don't have any other familiars, he will just shoot normal tears.

Counts as 1 of 3 familiar items needed towards the Conjoined transformation.

Type: Passive, Familiar

Item Pool: Item Room

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

Isaac's Tears

ItemID: 323

"Collected tears"

A spacebar item that fires 8 of Isaac's tears in a circle around him.

Tears spawned from this item keep most effect that Isaac currently has applied to his tears.

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

Type: Active

Recharge Time: 1 bar per tear fired

Item Pool: Item Room

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

Undefined

ItemID: 324

"Undefined"

Upon use, teleports you to one of the following rooms at random: Item room, Secret room, Super secret room, the I AM ERROR room or the Black Market (very low chance).

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

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

Type: Active

Recharge Time: 6 rooms

Item Pool: Item Room

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

Scissors

ItemID: 325

"Lose your head"

When used will cut your head from your body. Isaac's head will remain stationary and fire tears. His body can be controlled and spews blood nearby.

Tears fired by the head do a flat 3.5 damage and don't scale.

UNLOCK: Unlock this item by dying 100 times.

Type: Active

Recharge Time: 2 rooms

Item Pool: Item Room

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

Breath of Life

ItemID: 326

"Invincibility at a cost"

While you hold the spacebar down with this item, it will empty the charge bar gradually. When the charge bar gets to zero it will grant you a brief period of invincibility.

If the spacebar is held for too long (about 1 second) when it has no charge, you will take damage.

The invincibility effect is shown via a rapid flashing animation.

Type: Active

Recharge Time: Timed (1 bar per second)

Item Pool: Angel Room

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

The Polaroid

ItemID: 327

"Fate chosen"

After taking damage, if you have half a red heart or less, The Polaroid will give you an invincibility shield for 5 seconds.

Grants access to the Chest floor.

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

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

Type: Passive

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

*, photo, family, kodak

The Negative

ItemID: 328

"Fate chosen"

After taking damage, if you have half a red heart or less, The Negative will deal 40 damage to all enemies in the room.

Gives you access to the Dark Room floor.

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

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

Type: Passive

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

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

The Ludovico Technique

Special item

ItemID: 329

"Controlled tears"

You no longer shoot tears and instead now control a single large tear with the arrow keys.

Items which increase your tears stat will cause the tear to deal damage at a faster rate.

Items which increase your shot speed cause the tear to travel faster across the screen.

Ludo and Brimstone create a large controllable red ring of death that does massive damage to anything in its path.

Taking this with Mom's Knife allows you to remote control the knife around the room, dealing huge damage.

Type: Passive, Tear Modifier

Item Pool: Item Room

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

Soy Milk

ItemID: 330

"DMG down + tears way up"

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

-80% Damage Down.

x0.5 Tear Size.

Was a special item prior to Afterbirth.

Type: Passive, Tear Modifier

Item Pool: Item Room

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

GodHead

Special item

ItemID: 331

"God tears"

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

+0.5 Damage Up.

+1.2 Range Up.

-0.3 Tears Down.

-0.3 Shot Speed Down

+0.8 Tear Height.

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

Type: Passive, Tear Modifier

Item Pool: Angel Room

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

Lazarus' Rags

ItemID: 332

"Eternal life?"

Gives Isaac an extra life on death, exactly the same as Lazarus' default respawn effect.

When you die with this item, you respawn in the same room with 1 heart and the Anemic item.

The game considers you to be a different character (Lazarus II) when this effect activates.

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

Type: Passive

Item Pool: Item Room, Angel Room

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

The Mind

ItemID: 333

"I know all"

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

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

Type: Passive

Item Pool: Item Room, Angel Room

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

The Body

ItemID: 334

"I feel all"

+3 Health Up.

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

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

Type: Passive

Item Pool: Item Room, Angel Room

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

The Soul

ItemID: 335

"I am all"

+2 Soul Hearts.

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

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

Type: Passive

Item Pool: Item Room, Angel Room

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

Dead Onion

ItemID: 336

"Toxic aura tears"

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

-0.25 Range Down.

-0.4 Shot Speed Down.

-0.5 Tear Height.

x1.5 Tear Size.

Despite the increase in tear size, Dead Onion does NOT increase your damage stat. It also doesn't do poison damage despite having the tagline 'toxic aura tears'.

Type: Passive

Item Pool: Item Room

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

Broken Watch

ItemID: 337

"I think its broken"

Upon entering every 4th unexplored room, the Broken Watch will either slow down or speed up all enemies in the room.

The slow effect is much more common than the speed up.

An item only found in the Shop item pool.

Type: Passive

Item Pool: Shop

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

Boomerang

ItemID: 338

"It will never leave you"

A blue boomerang which can be thrown in a similar fashion to Mom's Knife, to stun any enemies it hits and deal damage.

The damage dealt by the Boomerang is equal to double your tear damage.

The boomerang can also be used to grab pickups and consumables from a distance, similar to the legend of zelda boomerang.

The range of the boomerang is affected by range, with number one the distance is very short and makes the item a lot less effective.

The Boomerang can be used to kill shopkeeper corpses, allowing you to farm their drops for coins, items, Steam Sale etc.

Type: Active

Recharge Time: Timed (A few seconds)

Item Pool: Shop

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

Safety Pin

ItemID: 339

"Evil up + range + shot speed"

+5.25 Range Up.

+0.16 Shot Speed Up.

+1 Black Heart.

+0.5 Tear Height.

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

Type: Passive

Item Pool: Boss Room

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

Caffeine Pill

ItemID: 340

"Speed up + size down"

+0.3 Speed Up.

Decreases the size of Isaac, and your player hitbox, making you less likely to be hit.

Gives you a random pill when picked up.

An item only found in the boss room pool.

Type: Passive

Item Pool: Boss Room

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

Torn Photo

ItemID: 341

"Tears + shot speed up"

+0.7 Tears Up.

+0.16 Shot Speed Up.

Type: Passive

Item Pool: Boss Room

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

Blue Cap

ItemID: 342

"HP + tears + shot speed down"

+1 Health Up.

+0.7 Tears Up.

-0.16 Shot Speed Down.

An item only found in the Boss Room pool.

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

Type: Passive

Item Pool: Boss Room

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

Latch Key

ItemID: 343

"Luck up"

+1 Luck Up.

+1 Soul Heart.

Spawns 2 keys on the ground.

Type: Passive

Item Pool: Boss Room

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

Match Book

ItemID: 344

"Evil up"

+1 Black Heart

+3 Bombs

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

Type: Passive

Item Pool: Boss Room

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

Synthoil

ItemID: 345

"DMG up + range"

+1.0 Damage Up.

+5.25 Range Up.

+0.5 Tear Height.

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

Type: Passive

Item Pool: Boss Room

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

A Snack

ItemID: 346

"HP up"

+1 Health Up.

Type: Passive

Item Pool: Boss Room

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