Bomb Bag

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

Sack Of Pennies

Isaac is followed by a small bag that drops a coin every 2 rooms.
Usually a penny, sometimes a nickel.

Little C.H.A.D.

Isaac is followed by Little C.H.A.D, who will drop a half Heart every 2 rooms.

The Relic

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

Bum Friend

A portable beggar who will follow you, pick up coins for himself, and occasionally drop Pick Ups. Does not spawn Collectibles.
The beggar pushes bombs around, he does this to spite you

Brother Bobby

Follows Isaac around shooting normal tears.

Demon Baby

Follows Isaac and automatically fires at enemies in its reach.

Little Chubby

Adds a small grub that follows Isaac.

Charges forward and deals touch damage to any enemies in his path. Will attack when the player attacks with a moderate cooldown time before he can attack again.

Little Gish

Follows Isaac around shooting tar projectiles that reduce enemies' movement speed, shot speed, and range for a few seconds.

Little Steve

Follows Isaac around shooting homing projectiles

Robo-Baby

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

Sister Maggy

Follows Isaac around shooting blood tears.

Abel

Mirrors Isaac's movements. Shoots in opposite direction to the player.

Ghost Baby

Familiar that shoots spectral tears.

Harlequin Baby

Familiar that shoots a pair of tears diagonally every second while Isaac is firing.

Rainbow Baby

Tear Effect changes every shot.

Forever Alone

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

Distant Admiration

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

The attack fly can deal damage to all enemies, unlike the other flies which can only block shots and hurt enemy flies.

Deals more damage than Pretty Fly / Forever Alone.

Guardian Angel

Spawns a guardian angel that orbits Isaac.

Does damage on touch, blocks bullets and doubles the speed of other orbiting items.

Halo Of Flies

Grants 2 Flies that circle Isaac.

Blocks bullets and damages fly enemies on touch.

Grants a Fly similar to those from Halo Of Flies.

Obtained from a Slot Machine or a Pill effect by the same name.

Sacrificial Dagger

Dagger orbits Isaac, very high damage.

Dead Cat

Your HP is set to 1.

You are followed by a floating cat head and have 9 lives (these still count as deaths on the statistics screen).

You can increase your max HP as normal, but after each death it will reset to 1 again.

1UP

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

Guppy's Hair Ball

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

Grows bigger by killing enemies

The first pick up gives a floating cube similar to a Pretty Fly that damages enemies.

The second pick up changes it into a floating head that shoots red tears.

The third pick up changes it into a humanoid Meat Boy, who walks around chasing enemies, but no longer shoot projectiles.
(This form pushes bombs around, it does this to spite you)

The fourth pick up increases his size and damage.

A fifth pick up will create another cube of meat orbital which then advances to another Super Meat Boy.

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