Familiar

A host of familiars.

A Familiar is a subtype of passive items. Familiars are small companions that float around you and will assist you on your journey. The effects from these can vary and goes from shooting along with you to blocking incoming projectiles, or something completely different.

Spawners

Item icon	Item name	Effect
File:Bag of Bombs IT.png	Bomb Bag	Drops a random Bomb, 1+1 Free, or Troll Bomb upon completion of every 3 rooms. Unlocked by completing Sheol with Cain.
File:Sackofpennies.png	Sack of Pennies	Drops money upon completion of every two rooms. Usually a penny, sometimes a nickel. Unlocked by beating Mom's Heart with Cain.
File:Little-chad-2.png	Little C.H.A.D.	Drops a half Heart upon completion of every two rooms. Unlocked by defeating C.H.A.D.
File:The relic.png	The Relic	Drops a soul heart upon completion of every 4 rooms. Unlocked by beating Mom's Heart with Magdalene.
	Bum Friend	Portable beggar that picks up coins for itself to use when you are not in battle. After getting random amount of coins, he drops a pickup. Dimes and nickels will be counted as getting multiple coins in a row, so it is more likely he will drop a more pickups.

Extra Lives

Item icon	Item name	Effect
File:Dead Cat.png	Dead Cat (Guppy)	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. Keep in mind that even if you have more than three heart containers, you will only have one heart container left once you purchase Guppy, since it sets your HP to 1 immediately, not after your first death. If you buy him for the price of 2 hearts from the devil and you have 2 or fewer hearts, you will acquire him, die, and respawn with 1 heart (therefore losing 1 of the extra lives). The cost of purchasing items in the Devil Room must be met to purchase them, but if it would kill you, you will respawn.
File:1 up.png	1UP	Gives the player an extra life and if you have "Sister Maggy" it will turn her into the "Brother Bobby" until you leave the current room. Note: Can be picked up multiple times through one playthrough.

Shooters

Item Icon	Item Name	Effect
	Brother Bobby	Follows the player around shooting projectiles.
File:FFS Demon Baby.png	Demon Baby	Follows you and automatically fires short range shots from any angle at enemies near you. Does not shoot if there are no enemies in the room or out of range. Does not shoot across pits. Unlocked by completing Sheol with Eve.
	Little Chubby	Adds a small grub to your shots. He acts as a piercing projectile so he can hit enemies multiple times while passing through and is only stopped by walls/poo/blocks. So far the highest damage Companion. Unlocked by defeating all of the Caves bosses.
	Little Gish	Follows Isaac around shooting tar projectiles that slow enemies down. Unlocked by killing the Gish alternate boss, also dropped by him.
	Little Steve	Follows Isaac around shooting homing projectiles. Unlocked by killing the Steve alternate boss, also dropped by him.
	Robo-Baby	Follows the player around, shooting enemies with an eye laser. Unlocked by completing the game with Judas.
	Sister Maggie	Follows the player around shooting bloody tears.
	Abel	Mirrors your movements, acting as a friendly Dople. Unlocked by completing Cathedral as Cain. File:Abel.png
	Ghost Baby	Follows the player around shooting spectral tears.
	Harlequin Baby	Follows the player around shooting diagonal tears.
	Rainbow Baby	Follows the player around. Fires tears with different effects each shot. Unlocked by completing Cathedral as ???. File:Rainbowbaby2.png

Orbitals

Item Icon	Item Name	Effect
	Forever Alone	Spawns a blue attack fly that orbits a long distance from you. Doesn't deal as much damage as Distant Admiration.
	Distant Admiration	An attack fly that circles further out than the Halo of Flies/Pretty Flies. The attack fly can deal damage to all enemies, unlike the other flies which can only block shots and hurt enemy flies.
File:Guardian Angel IT.png	Guardian Angel	Increases faith just like the Rosary. In addition, also blocks incoming projectiles like Pretty Fly, Cube of Meat level 1 and 2, and the Halo of Flies. It also causes itself and any other projectile blocking power up to spin twice as fast around the character, making the overall shield more effective. Damages enemies upon touch. Unlocked by completing Sheol with Maggy. They presumably meant "Guardian Angel" but it's spelled this way in the collection. Possibly a reference to "the guardian" british newspaper, often mocking called the guadrian due to the high number of typos.
	Halo of Flies	Grants 2 Pretty Flies that circle the player, blocking enemy shots that hit them. These kill other flies that touch them. Can stack with a Pretty Fly and itself to reach the maximum of three flies.
	Pretty Fly	A Fly will circle the player, killing other flies that touch it and occasionally blocking enemy shots. More than three has no effect. Obtained from the slot machines or a pill effect by the same name. Note: The pill image is generic, any unidentified pill can be a Pretty Fly Pill and will become identified when consumed for the remainder of the current game. See Pills.
	Sacrificial Dagger	A dagger orbits around Isaac similar to a Pretty Fly. Much higher damage compared to other orbitals. Unlocked by completing Cathedral as Eve.

Super Meat Boy

Item Icon	Item Name	Effect
	Cube of Meat	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.(It appears that it will shoot a projectile every 1/3 way of it's orbit, it might be the same speed for all others ie: Brother Bobby) 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. Before Halloween Update: The fifth pick up increases his speed and changes his sprite into a Gusher. The sixth pick up reverts it back to the previous, the fourth, form. After Halloween Update: A fifth pick up will create another cube of meat orbital which then advances to another Super Meat Boy. Unlocked by completing The Depths. A reference to the game Super Meat Boy. → →→

Guppy's Hairball

Item Icon

Effect

Loosely follows behind Isaac. Can be swung like a flail by rapidly spinning Isaac in a circle. Deals damage when it collides with enemy units. If an enemy unit is killed by the ball it increases in size up to a maximum limit. The larger the ball becomes the easier it is to swing, the larger its collision circle becomes, and the higher its damage becomes. Size is reduced at the start of each floor.

Attack Flies

Attack Flies are small blue flies that circle the player, these flies follow a loose orbit that will shift and sway as the player moves. Attack flies will, when in range, break away from their orbit and chase after an enemy dealing touch damage and frequently dying themselves. Attack flies can occasionally survive an attack on weaker enemies and will return to their orbit or attack again if this is the case.

There is no limit to the number of attack flies that can hold orbit around you, though only 5 will follow you from room to room, so after leaving a room the rest will disappear automatically.

These flies can be found from Pills (Friends 'Till the End), Red Chests, The Fish Head Trinket, Infestation and the Mulligan treasures.