Item Name and Icon

Effect

Rooms to Re-charge

Anarchist Cookbook

Spawns six troll bombs around the room.

Frequently dropped by Pride.

The Tower Tarot Card has identical effect.

3

The Bean

Causes the player to have bad gas, damaging and poisoning any enemy in close vicinity.

(Same as the Bad Gas pill)

1

Bob's Rotten Head

Throws a bomb in the direction Isaac's facing. It does extreme damage, poisons the enemy for 5 seconds, and destroys rocks.

Isaac can be damaged by the explosion if he is within the blast (though he cannot be poisoned).

Bombs will arc back towards Isaac with the My Reflection upgrade.

Bug: Dealing poison damage to War while off screen causes him to get stuck in the walls.

Sloth and Pestilence are highly resistant to the blast and immune to the poison. Appears in secret rooms or as a drop from Sloth.

3

The Bible

6

Book of Belial

Increases damage until you exit the room, similar to The Devil tarot.

Unlocked by beating the full game. Can rarely be found in secret rooms and the devil room. Judas starts the game with this item.

3

The Book of Revelations

Adds 1 Soul Heart.

Holding the book will increase the chances of meeting any of the Horsemen, though you have to use the book in the level at least once.

NOTE: After much experimenting, it appears that if you START the level WITH the book and USE it at least once before facing the boss, it will be a Horseman. Acquiring it and using it on the same level may not always result in a Horseman boss.

Holding the book may also cause you to fight the Headless Horseman in Sheol instead of the final battle with Satan. Unlocked by killing any of The Horsemen.

This item is most commonly found in shops, but it can also be found in the devil room or even in the item room. It's also a rare drop by the beggar.

6

Book of Shadows

Grants invulnerability for 12 seconds. Will start flickering before stopping.

Greed still knocks out your coins if you get hit by the triple shot. This cannot be used to get items from the devil room without paying.

You can farm Blood Donation Machines for free while this item is activated.

Trivia: This book is a reference to the book used by the witch sisters in the TV series Charmed

3

The Book of Sin

Spawns a random pick-up, pill or tarot card.

4

Dead Sea Scrolls

Uses a random Activated Item (even locked ones), or gives you a random collectable item.

4

Deck of Cards

Gives the player a random tarot card.

6

The D6

Re-roll all activated and collectable items on screen (swaps pedestal/s with random item/s).

By extension, this means it can also be used to change shop merchandise or boss drops. The exception is with special drops from alt bosses, like Cube of Meat from the Horsemen or Little C.H.A.D. from C.H.A.D., which will simply replace them with the same item.

Bug: It is possible to exploit this nature to obtain 2 Cubes of Meat from 1 Horseman. Using The D6 while a Cube of Meat is onscreen can change other items, such as a Small Rock or an item from a Beggar spawned with XX Judgement, to turn into Cubes of Meat (for example, here are 3 cubes on one screen).

Bug: There is a small chance that the new item will be a constantly changing item that is called 'Undefined item' upon collection. Upon pickup, nothing is given. Re-rolling the item will not change it, so the item is effectively lost. If 'Undefined item' is rolled in the secret room, then that item will appear in all future secret rooms in the same playthrough. {C}Unlocked by completing The Womb with ???.

After being unlocked, Isaac starts the game with this item.

3

Doctor's Remote

Sets a big red target on the ground which can be controlled with the arrow keys. After several seconds, a huge explosive missile hits it.

Trivia: This item is a reference to an item used by Dr. Fetus from Super Meat Boy.

It can blow up rocks and the secret room.

3

Forget Me Now

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

Using this effectively forces you to abandon your current Activated Item.

This item is a reference to Arrested Development, where the character Gob calls "roofies" Forget Me Now.

Unlocked by completing Sheol with ???.

N/A

The Gamekid

The user turns into a Pac-man-like creature, gaining invincibility, the ability to damage enemies on touch, heal upon enemy death, and causes enemies to run away for 5 seconds.

Health leech will not work on bosses unless delivering the killing blow - it will however work on monsters spawned by bosses, granting in that case, soul hearts.

The health leech also does not work with ???.

There is a bug when using the Gamekid with Technology. The controls will be inverted for the left and right fire until you leave the room.

When used in the Devil room, the Heart colors appear darker, but these are NOT turned to soul hearts (buying an item will cost normal hearts).

This item is a reference to the Nintendo Gameboy, one of the first portable gaming systems.

Unlocked by visiting arcades 10 times.

6

The Hourglass

Bug: When this item is used on bosses that fire exploding arced shots (Sloth, Pestilence, etc.), twice the normal amount of the shots are fired.

If used while the fallen copies himself, the fallen becomes 4, instead of 2

2

Kamikaze!

Makes Isaac explode, dealing one heart's worth of damage.

Unlike Blood Donation Machines, this will use up your Soul Hearts as well. Affected by The Wafer's damage resistance.

This does not count towards "take no damage" achievements.

0

Lemon Mishap

Flying enemies are not damaged by the pool.

Similar, to Peep's ability.

2

Mom's Bottle of Pills

Spawns a random pill.

A player will only receive six different pill types in one playthrough.

Unlocked by using a Blood Donation Machine 20 times.

6

Mom's Bra

Causes the player to wear the bra for a short period of time and freezes enemies for the next 5 seconds.

If used on Mr. Maw, the usual Maw will appear after the freeze effect ends.

Bug: If this item is used on Satan when his hoof is down, then killed during the freeze effect, the Devil Statue will reappear and the player will be unable to do anything.

Bug: If used on Fistula, this can cause divisions of the boss to get stuck on rocks.

3

Mom's Pad

3

Monster Manuel [sic]

Summons a random familiar (even locked ones) for the current room only.

Trivia: This item's name and graphic are both references to the AD&D Monster Manual.

Summoning "A Cube of Meat" will summon a random level of Meat Boy (1 through 4).

Unlocked by completing Sheol with Judas.

4

Monstro's Tooth

Monstro jumps onto a random enemy, doing damage.

Monstro can do damage to you if he lands on you or you walk into him. This cannot be used against Monstro.

Note: Despite the fact that it can't be used on Monstro it can be used on Monstro II.

Bug: If used on War when he jumps up to drop Troll Bombs, he will become stuck and the player will be unable to do anything.

Unlocked by beating all bosses in The Basement.

3

Mr. Boom

Drops a large bomb.

It has an increased blast radius of 3 squares in contrast with the 2 squares of regular bombs.

Does not destroy doors like normal bombs.

2

My Little Unicorn

Grants Isaac temporary invincibility while damaging enemies by touch.

Isaac cannot fire unless he's holding Mom's Knife.

Bug: You can farm 'Blood Donation Machines' for free while this item is activated.

6

The Nail

Turns Isaac's body black with twisted horns, adds one Soul Heart and allows the breaking of rocks by simply walking over them. Increases damage by 1 and decreases speed by 1. Also allows the breaking down of the Challenge Room door.

6

The Necronomicon

Damages all enemies in the room significantly.

Unlocked by using the Death Tarot Card 4 times.

6

A Pony

While equipped, increases speed by 2 and allows Isaac to fly over rocks, pits, blood, and spikes.

Upon use Isaac will charge in the direction selected and deals damage to monsters.

Can be used to hit the Blood Donation Machine without taking damage.

This is a possible reward from defeating the Headless Horseman (the other being the Cube of Meat).

The Pony is the only spacebar item with a passive effect while it is equipped. If it is replaced by another item, these bonuses are lost.

Because it gives flight, this also allows you to enter and exit the Challenge Room while the gate is up.

6

The Poop

Drops a pile of poop, exactly like the ones that litter the basement.

As with the poop in the basement, destroying it may yield coins or hearts.

Unlocked after 10th playthrough.

??? starts the game with this item.

Charges after every room.

1

Razor Blade

Deals a certain amount of damage to self, in exchange for increased damage in the current room.

As with the Blood Donation Machine, this uses up your heart containers first before it takes your Soul Hearts.

Unlocked by completing The Womb by Eve.

Will cause death if it removes all remaining hearts from heart containers, even if Soul Hearts remain.

0

The Pinking Shears

Separates Isaac's head and body for a single room. Control is retained for his flying head while his decapitated body will automatically attack enemies in range dealing high damage (essentially a powered-up Meat Boy).

Found in the Item Room.

6

Shoop Da Whoop!

Fires a laser from Isaac's mouth. Using the item charges the laser- it can then be fired in the chosen direction. The laser penetrates all obstacles and enemies in its path and can damage multiple enemies.

Trivia: This item is a reference to an internet meme of the same name originating from 4chan depicting a face similar to the icon firing a lazer.

This item can sometimes be dropped by Envy.

3

Tammy's Head

Shoots 10 projectiles in a circle around you.

Modifiers to your primary fire also modify the tears used for Tammy's Head as well (eg. Boomerang Shot, Homing Shot).

Charges after every room.

Tears do not turn into Brimstone lasers, Technology lasers, or Dr. Fetus bombs and will behave as any tears Isaac would fire should he not have any of the items mentioned.

(Note: Tears fired by Tammie's Head do highly incresed/max damage.)

1

Teleport!

Teleports the player to a random room, including secret rooms and the boss room.

Can teleport to the I AM ERROR room, otherwise only accessible via Teleport or the consumption of Telepills. Chance of this happening varies between 5% and 10% per teleport, chance lowers as floors increase in number of rooms.

If Isaac teleports into the Devil Room before beating the boss, he will leave to the first room on the level. This potentially allows to skip Mom's Heart entirely.

Can also be used (along with other player moving items) to "reroll" champion bosses for a different version by use during the boss fight.

2

We Need to Go Deeper

Creates a trap door to go to the next level.

Using on Womb 2 creates a trap door to Sheol (even if Sheol has not been unlocked yet). Will not have an effect in Sheol.

Does not count for certain achievements that require going through an area without getting hurt if used in the second part of a level (Basement 2, Cave 2, Depth 2 and Wombs 2) because the second boss must be killed to unlock said achievement. Nevertheless, for these achievements, this item can be used in the first part of a level (Basement 1, Cave 1, Depth 1 and Wombs 1). proof link

This item appears in secret rooms or the devil room, and is a possible drop from The Fallen.

6

Yum Heart

Restores 1 whole heart.

Unlocked by having seven heart containers.

Useless with "???"

Magdalene starts the game with this item.

4

Item Icon and Item Name

Effect

Visual Effect

Collection Grid

<3

Increases available heart containers by 1 and restores all health.

Trivia: This item beats in a similar way as the heart seen in the title screen of Spewer, another game from Edmund McMillen.

This item is sometimes dropped by Gluttony and can be found in shops.

Attaches a beating heart to Isaac's chin.

1UP

Gives the player an extra life in that upon death Isaac will respawn in the previous room with full health.

Stacks with Guppy (Dead Cat). Has priority over Guppy if the player has accquired an HP increasing collectible since obtaining Guppy.

Can be picked up multiple times in one playthrough.

Bug: Sister Maggy or Little Steve will turn into Brother Bobby until exiting the room.

Bug: Having an 1UP while doing a deadly trade with the devil, results in a rebirth with 0 hearts, unless Guppy was bought before.

Bug: Dying as you defeat a boss can provide you with both the item you earned and an opportunity to fight the boss a second time, earning a second item.

This appears in secret rooms.

9 Volt

Upon pickup, Isaac's current activated item will be fully charged.

This item is most common in shops.

Makes a battery appear smashed into his head.

Battery

Gives the player an extra charge every 15 seconds per room, up to a maximum of 3 charges. Using an item will reset the counter and let the player charge a maximum of 6 bars per room.

If used in conjunction with X-Ray Vision / Dr Fetus', this allows an infinite use of the activated item by running between uncompleted rooms and the secret room / blowing up the a door of an uncompleted room, running out and in again. Using The Book of Revelations or The Nail for example can provide unlimited Soul Hearts.

This item is most common in Shops and an be dropped by beggars.

Makes Isaac have Frankenstein bolts on his neck.

The Belt

Increases Speed by 2.

Found in the Boss Room or in the Item Room.

Gives Isaac a belt.

Blood Bag

Increases HP by 1, Speed by 1 and restores 4 hearts.

Can be won and picked up multiple times during one playthrough.

The Blood bag and A Dollar rewards can be "rolled" with the D6.

Final reward from Blood Donation Machine.

Makes Isaac have blood stained face.

Blood of the Martyr

Makes Isaac have a crown of thorns.

Bobby-Bomb

Gives 5 bombs and causes all bombs to slowly slide towards the closest enemy.

If the player has the Dr Fetus powerup (converting tears to bombs) then it also applies to those.

Bobby-Bomb affects Wrath's bombs as well, causing them to move toward Wrath.

Bomb Bag

The Character is followed by a small bag that drops a Bomb, 1+1 Free, or Troll Bomb upon completion of every 3 rooms.

Unlocked by completing Sheol with Cain.

Familiar: Follows the player.

Boom!

Gives 10 bombs.

Found in the Item Room or Challenge Rooms.

Adds a lit fuse to Isaac's head.

Breakfast

Increases HP by 1.

Found in the Boss Room.

Brimstone

Changes tears to a chargeable laser that pierces all objects in its path be they rocks, poop or Knights. It can only be fired after a short charge-up period (approximately two seconds or until Isaac's head flashes red). The laser is channeled for about two seconds so it is possible to destroy some two-stage enemies in one shot (Globins and Hives along with the flies they spawn on death), or to strafe the shot over multiple enemies.

It is possible to charge before entering a room so that the first shot can be fired immediately. (for half its damage)

It should be noted that another shot can be charged during the attack animation of the first. To attack at maximum speed, release to attack and then instantly start holding again to fire about a second after the first blast is done.

Using it with Chocolate Milk allows the character to fire before completely charging the attack (doing less damage). Charging up a shot before entering a new room is pointless with this combo, since the attack will do no damage.

When used with The Inner Eye, it will cause Brimstone to charge 3 times slower, but also cause it to deal 3 times as much damage.

Mom's Knife will override this effect making this power-up useless.

Increasing Tears reduces charge up time of Brimstone.

Increasing DMG does increase Brimstone's damage

Removes knockback effect of tears.

If you already have Technology and you pick up Brimstone, brimstone will override Technology.

If you already have Dr Fetus and you pick up Brimstone, brimstone will override Dr Fetus.

If you have Steven/Chocolate Milk and Brimstone at the same time, you can instantly fire a blast for a smaller amount of damage by just tapping/clicking the attack button.

Brimstone's charge (open mouthed laser) will overlap any item that is on the player's face, this is obviously a graphical bug.

Available in Devil Room for 2 hearts' or as a reward after fighting The Fallen.

Brother Bobby

Bucket of Lard

Gives two empty heart containers, heals by half a heart but decreases speed.

This item is rarely dropped by Gluttony. Can also be found in Item rooms.

Isaac appears significantly fatter than usual.

Charm of the Vampire

Killing 13 monsters heals the player for half a heart.

This can be used to the player's advantage when fighting Globins. Every time they get to the ooze form, it counts as a kill. Therefore, if Charm of the Vampire is present, one could get several hearts by shooting at Globins but not completely killing them, and when they revive, repeating the process.

Splitting apart Envy, Fistula, and The Fallen will count as one kill. Killing Flies does not increase the counter.

If the kill counter reaches 13 while at full hearts, the counter resets and the heal is wasted.

Useless to ???

Issac gains a smirk and sports a widow's peak similar to that of the original Dracula, as well as vampiric fangs.

Chocolate Milk

Allows the player to charge shots making them a lot stronger and larger, and turns them brown.

Increases the damage of Technology, firing speed of Spoon Bender, amplifies The Inner Eye after a slightly longer charge, and causes Mom's Knife to do increased damage. Allows Brimstone to be fired with a partial charge for less damage, but causes it to do no damage if you charge before entering a room and firing.

A good combination with Chocolate Milk is an auxiliary shooting familiar like Little Steve or Brother Bobby. This is because while you are charging up your shots, your auxiliary familiar will continue shooting. This can buy you time so you can fully charge up.

Cheeks inflate while shots are charged.

The Common Cold

Gives the player's shot a chance of poisoning enemies for 2.5 seconds and turns tears green.

The effect is retained when combined with Technology or Brimstone. The Technology laser will turn green, while the Brimstone laser will keep its original color.

Unlocked by collecting two of either Roid Rage, The Virus, or Growth Hormones in one session.

Instead of crying, Isaac will now spit green projectiles.

The Compass

Does not reveal secret rooms. This will reveal if Greed is present by displaying a mini-boss icon with the shop icon.

Common in shops and occasionally found in Challenge Rooms. Available from the Beggar. Never found in Item Rooms.

Cube of Meat

This item can stack and has different effects based on how many cubes have been collected.

The first pick up gives a floating cube similar to the Pretty Fly that damages enemies it touches and blocks projectiles.

The second pick up changes it into a floating head that still damages on touch and blocks projectiles, but now also spits blood shots.

The third pick up changes it into a humanoid Meat Boy, who walks around chasing enemies, but no longer shoots projectiles. On occasion, it will unintentionally shove items aside while following you or attacking enemies, including bombs.

The fourth pick up increases his size and damage. (He still shoves items.)

Collecting a 5th Cube of Meat will do nothing. (Bug with "headless boy" was fixed http://www.youtube.com/watch?v=6jPdDbhE6mo)

Note: If you have more than two Pretty Flies, the Cube of Meat will circle Isaac where the third fly should be, though the fly will still be visible.

Unlocked by completing The Depths.

> > >

Orbit: Circles around the player.

Familiar: Follows the player.

Cupid's Arrow

Gives the player piercing shots that will travel through and damage multiple enemies and cause damage to Knights from the front. Shots don't go through obstacles.

Removes knockback effect of tears.

If you have Parasite and Cupid's Arrow, tears will no longer split when they hit enemies.

Isaac wears a Native-American headdress.

Dead Bird

Whenever Isaac takes damage, the bird starts attacking nearby enemies while flying over obstacles. The effect only lasts for the current room.

This item can be activated through self-damage.

Eve starts the game with this item.

Familiar: Follows the player after activation.

Isaac: A small bird trinket is on Isaac's head.

Guppy (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. (1 soul heart with ???)

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, but if it would kill you, you will respawn.

Bug/Exploit: After defeating a boss, if you die after the item appears but before the boss disappears you will be able to fight the boss a second time for yet another item. (Pick up the item, then kill yourself with a bomb or something similar. You will then respawn outside the boss room with one less life on your counter. Going back inside the boss room allows you to now fight the boss again for another item. Can be done as long as you have additional lives on your counter. Can also be performed after picking up a 1UP.)

Guppy will sometimes appear as a collectable item as well as in the Devil room. Collecting more than one Guppy will not add any more lives if the player already has 9, but will reset your health back to 1.

Dessert

Increases available heart containers by 1.

Found in the Boss Room.

Dinner

Increases available heart containers by 1.

Found in the Boss Room.

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.

Orbit: Circles around the player.

Demon Baby

Confirmed to take on the effects of the player's own projectiles, like the Spider's Bite's slowing effect and Mom's Contacts' freeze effect.

Unlocked by completing Sheol with Eve.

A Dollar

The A Dollar and Blood Bag rewards can be "rolled" with the D6.

A final reward from Slot Machines; they come out when the machine explodes from overuse.

Automatically unlocks Cain

Dr Fetus

Replaces the player's shot with a bomb. Only one bomb can be shot at a time, and it will slide a fixed range before exploding. The bomb slides over pits, and can be pushed around. Bombs detonate faster as the Tears stat increases.

With the Chocolate Milk, bombs will have a bigger blast radius when charged, but only in the room in which Chocolate Milk is collected. Once the player leaves that room, the bombs function normally again. This is likely a bug.

With the Ouija Board, Bombs will also slide through Rocks.

With The Common Cold, Bombs will add a poison effect.

With Mom's Contact or Parasite, bombs will be colored red.

If you have Dr Fetus and Technology at the same time, you will fire both a bomb and laser simultaneously.

Will NOT override Brimstone, but will BE overridden by it.

Substantially increases the likelihood of bomb-related upgrades.

The Bobby-Bomb and Mr. Mega upgrades improve Dr. Fetus bombs as well.

Bug: After Globins collapse in a pile and then revive, the bombs will pass through them, making them much harder to hit.

Unlocked by completing the game 5 times.

A rare find in the Item Room and Shops.

When fired and shot at by Little Gish, the bombs will appear black and may slow any surviving enemies.

Isaac sports the familiar top hat and monocle of Dr. Fetus from Super Meat Boy, another game made by Edmund McMillian.

Forever Alone

Doesn't deal as much damage as Distant Admiration.

Orbit: Circles around the player.

Guardian Angel

This will also cause all orbiting items/familiars (Pretty Flies, the Cube of Meat, Distant Admiration, Forever Alone, and the Guardian Angel itself) to orbit at roughly double speed.

Trivia: The misspelling of 'Guardian' within the game ('Grauniad') is a reference to the British newspaper "The Guardian"'s tendency to make typographical errors, a joke popularized by 'Private Eye'

Unlocked by completing Sheol with Maggy.

Found in the Item Room.

Orbit: Circles around the player.

Growth Hormones

Bug: The growths remain tan when Isaac's body is turned into another color due to color-changing items.

Issac receives inhuman growths on his head.

The Halo

Unlocked by defeating either Mom or Mom's Heart by using The Bible.

Isaac sports a halo.

Halo of Flies

Grants 2 Flies that circle the player, blocking enemy shots that hit them. These kill other flies that touch them but do not damage other enemies.

Can stack with a Pretty Fly/Cube of Meat/Guardian Angel/Itself up to a maximum of three. Flies have the lesser priority regarding orbitals and are replaced by other orbitals when all 3 "orbital slots" are taken. Flies cannot replace other orbitals and nothing happens if picked up when already having three.

Found in the Item Room.

The Inner Eye

Gives the player a triple shot, sets Tears to minimum (Rate of fire).

If you have Technology, this will increase Damage to maximum and decrease firing speed to minimum.

If you have Brimstone, this will cause Isaac to fire a single beam that causes 3 times as much damage, but with an increased charge up time of 5 seconds.

It also negatively affects Dr Fetus bomb firing speed.

Chocolate Milk allows the triple shot to be fired more quickly for lower damage.

Isaac gains a third eye.

Ladder

It also confuses the pathfinding of all non-flying enemies. For example, Globins /Gapers will lose you and stop if you are standing over a gap. This is very useful against all non-shooting, non-flying monsters.

Bugs: It is possible to get stuck if you use the ladder to walk onto a tile surrounded by pits with a shooting stone skull. One can also get stuck by quickly moving onto a tile with a skull statue surrounded by pits, as the player will be pushed and trapped between two of them.

This item is fairly common in Shops.

Little C.H.A.D.

Drops a half Heart upon completion of every two rooms.

Useless to ???.

Bug: If the player already has Little Steve or Little Gish at the time of collecting Little C.H.A.D., Little Steve/Little Gish will be transformed into Brother Bobby for the duration of the room.'

Unlocked by killing either the alternate boss C.H.A.D., or if the Headless Horseman drops it.

Little Chubby

Adds a small grub that follows you.

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.

Chub's attack is affected by momentum, just as tears are. Thus, he can be shot diagonally.

Although Little Chubby has an enemy penetrating effect it will not damage Knights from the front like Cupid's Arrow or Technology will.'

Note: When you enter a new room the first shot will automatically activate Little Chubby.

Unlocked by defeating all of the Caves bosses.

Little Gish

Follows Isaac around shooting tar projectiles that reduce enemies' movement speed, shot speed, and range for 2.5 seconds.

Unlocked by killing the Gish alternate boss and is dropped after the boss fight.

Little Steve

The D6 can be used after the boss fight with the alternate boss Steve to give Steven instead of Little Steve, and vice versa.

Unlocked by killing the Steve alternate boss and is dropped after the boss fight.

Loki's Horns

Gives a random chance for projectiles to fire in a cross (+) pattern. This chance is increased with your Tears stat.

If the player has Mom's Eye and The Inner Eye the cross shot is always fired.

If the player shoots a charged Chocolate Milk shot, all of the cross pattern shots will be charged.

Bug: Sometimes it may appear before unlocking it.

Unlocked by defeating all of the Depths bosses.

Isaac gains small horns.

Lord of the Pit

The player can fly over all obstacles, including damage floors, spikes, rocks, and pits. (Same effect as Transcendence, but with different visual effects).

A useful technique when you have acquired Lord of the Pit is to hover over a pit and shoot at walking enemies like Globins and Gapers. These enemies cannot get to you as long as you are above the pit.

Trivia: There is an error in the spelling for the effect. It is quoted as "Deamon Wings". (This is a spelling error, but also might be an attempt at the old English spelling of the word, which is "daemon".)

Bug: This also allows you to enter the Challenge Room if you do not have enough hearts and the gate is down, as well as leave during the fight within.

Grants the player demon wings and turns the player's entire body black.

Lucky Foot

All pills picked up will have positive effects (same effect as the PhD but without pill identification). Increases the chance of getting items from piles of poo and fires. Increases the chance of winning the Skull Challenge in the Arcade room from 33% to 50%. Increases the chances of getting items from gold chests.

Cain starts the game with this item.

Found in the Item Room, the Boss Room and Devil Room.

Unlocked by collecting 55 pennies in one playthrough.

Creates a gold anklet on Isaac's left foot.

Lunch

Found in the Boss Room.

A Lump of Coal

Increases damage based on how far tears have traveled (tear size increases as it gets further away).

If the Lump of Coal is "rerolled" with the D6, it may be replaced by other Devil Room items. In this case, the item will not cost any hearts.

Found after fighting Krampus.

Coal dust on forehead. Tears are stained black.

Magic Mushroom

Fully heals the player, increases all their stats by 1 (including available heart containers) and increases tear size.

Will give ??? a Soul Heart instead of healing.

Player becomes visually larger.

Magneto

Note: It will also attract troll bombs towards the player.

Isaac has a magnet on his head.

The Mark

Increases Damage by 2 and adds one soul heart.

Will kill you if you have 2 or less hearts when you make the devil deal despite giving you one soul heart.

Available by defeating 'The Fallen' or traded in a Devil Room.

Isaac sports three 6's in a circular pattern.

Max's Head

Isaac's eyes grow bigger and more "shiny".

Mini Mush

Increases speed and range by 1.

Note: More than 1 can be found in a single playthrough

The player's size decreases.

Mom's Contacts

Gives the player a petrifying shot that will randomly freeze enemies solid for 2.5 seconds and turns tears bright red.

If the body of a Mr. Maw enemy is frozen when the head launched, the head will detach but then reattaches when the body is unfrozen.

Note: The freezing effect will not work on Mom, but it will work on It Lives and invulnerable enemies (Statues in The Depths, Knights attacked from the front, etc).

Unlocked by collecting Mom's Eye and any other Mom's item on the same run.

Isaac gains a red eye, similar to mom's (except red).

Mom's Eye

The shots from the back fire at random, so having a faster firing rate means a more common multi-shot.

Fires normal tears, even when used in combination with items like Technology.

Isaac gets another eye on the back of his head.

Mom's Heels

This is mainly a Boss Room item. It can rarely be found in other places.

Isaac wears mom's shoes.

Mom's Knife

Can also be used as a melee weapon, in which case it does high damage and possibly instantly kills any enemies that its edge touches.

It is possible through the use of two or more range down pills to make it impossible to throw the knife, effectively resulting in a forced melee mode.

The knife is tied to your base damage and shot effects (e.g. spider bite or chocolate milk).

Also, finding Dr Fetus after Mom's Knife does nothing except give you the monocle and top hat.

Having collected the Common Cold covers the blade in poison, to the point where it drips to the ground. Turns the blade gold or yellow when Number One is collected. Also turns the blade ghostly grey when the Small Rock is collected. If you pick up the Ouija Board your blade will become transparent.

And when you use My Little Unicorn (or the Chariot card) the Knife does not disappear, allowing you to stab, throw the knife, and charge around at the same time.

It is possible to increase damage enough to kill everything in one shot.

Note: Good interaction with Wiggle Worm, if thrown correctly it hits multiple times before returning, causing enough damage to kill Mom in 3 hits.

Collecting the spoon bender item will add a slight homing effect to Mom's Knife. The path of the knife will shift slightly towards an enemy and shift back on return.

Unlocked by beating Sheol with Isaac.

Isaac wields mom's knife.

Mom's Lipstick

This is mainly a Boss Room item. It can rarely be found in other places.

Isaac wears mom's lipstick sloppily.

Mom's Underwear

Found in the Boss Room or rarely in the Item Room.

Isaac wears moms underwear (Yuck!).

Money = Power

Found in the Item Room or Devil Room.

Unlocked by completing the game 8 times.

Isaac gets pimpin' glasses.

Mr. Mega

Note: If the player has the Dr Fetus powerup (converting your shots to bombs) then it also applies to those bombs.

Bug: When combined with the Bucket of Lard powerup, causes a flicker effect on the character (due to overlapping textures).

Unlocked by using a lot of bombs.

Found in the Item Room.

Gives the player a helmet/facial expression similar to Wrath, who in turn is a reference to Bomberman.

My Reflection

Gives the player's tears a boomerang effect and range is set to default range.

Note: Any additional range adds to the distance of the boomerang effect. However it ultimately limits your prime range to medium. Flinging the shots by firing while walking forward drastically improves the maximum distance they will travel with this upgrade. The shots are actually drawn to your current location, meaning that you can 'pull' them in a direction by walking that way. This also means that if they go through you, they will turn around and start heading back again, etc until they reach their maximum range or hit something.

Works well in conjunction with Ouija Board, Cupid's Arrow, The Inner Eye, Lump of Coal, and/or Spoon Bender.

Isaac gains a Sailor Moon type symbol on his forehead.

Number One

Combining Number One with Technology causes the fire rate to increase significantly and turns the beam yellow.

Bug: Collecting The Mark (and maybe other tear-changing items) before collecting Number One increases your rate of fire to max, but doesn't decrease your range.

Isaac stops crying and smiles while yellow colored projectiles (urine) come from his lower body rather than his face.

Odd Mushroom (Thin)

Makes player's head smaller.

Odd Mushroom (Large)

Found in the Item Room.

Makes player's head bigger.

Ouija Board

Shots will be stopped by stone-turret-heads, but they will be moved by the shot.

Tears go through fires, poo piles, TNT barrels and extinguish/destroy/detonate them at a slower rate than usual (unless combined with Technology, in which case they're all destroyed instantly). Familiars' shots are not affected by some of these changes. For instance, Brother Bobby's tears will still put out fires. Also works with Dr Fetus upgrade.

Available in thr Devil Room, Item Room or from Beggars.

Makes Isaac's head look "Undead" or "Souless".

The Pact

Increases Damage and rate of fire by 1. The player also gains 2 soul hearts.

If you have Transcendence when you pick up The Pact, you will have a body again, but with demon wings like the Lord of the Pit item grants.

(Will kill you if you have 2 or less hearts when traded for despite giving you 2 soul hearts.)

Available by defeating 'The Fallen' or traded in a Devil Room.

Turns the player's body black, gives him small horns, and makes him seem more aggressive.

The Parasite

Makes the player's tears split in two when they hit something. Sets firing rate to 1. Stains tears brown-orange.

Note: tears only split when they stop. That means with piercing upgrades (i.e. Cupid's Arrow) they won't split on enemies.

Unlocked by collecting two "dead things" (Bob's Rotten Head, Guppy, Max's Head, Tammy's Head) in a single playthrough.

A creature appears on Isaac's head that looks like the Parasite from the Flash-Game "The Visitor" from Zeebarf.

Pentagram

Increases Damage by 2. Increases chance for a Devil Room to appear.

Found in the Boss Room.

Isaac grows large horns.

PHD

Changes the effects of the Health Down pill to Health Up, Tears Down to Tears Up, Speed Down to Speed Up, Range Down to Range Up, and Bad Trip to Full Health. This also restores 3 health on pick up. Reveals pill names 5 seconds after picking up the pill.

Will not change pills that have been dropped beforehand.

Also increases coin payout from the Blood Donation Machine from 1-3 to 2-4.

Isaac wears a doctor's mask.

A Quarter

If seen in the Shop, always buy it if possible as you will make a profit.

Sometimes found in Item Rooms. Found in Devil Rooms costing either 1 heart or 3 soul hearts.

Unlocked after beating the game 4 times.

Raw Liver

Primarily found in Secret rooms. A rare drop from bosses or Gluttony.

The Relic

Bug: Turns Little Steve, Little Gish, Sister Maggy and/or Robo-Baby into Brother Bobby for the current room when collected.

Unlocked by completing the game with Magdalene.

Robo-Baby

Unlocked by completing the game with Judas.

Roid Rage

Isaac gets crazy looking.

Rosary

Isaac has a cross amulet.

Rotten Meat

Found in the Boss Room.

Sack of Pennies

Bug: If you already have Little Steve with you when you pick this up, he will bug out and turn into Brother Bobby until you leave the room.

Unlocked by beating the game with Cain.

The Sad Onion

Doubles the Tears Stat (Rate of fire).

Trivia: Possibly a reference to a running gag from Ashens' videos.

Isaac begins to cry much harder.

Sister Maggy

More powerful than Brother Bobby. (Blood tears deal more damage than normal tears.)

Skatole

Note: Boom Flies will still be harmful, but their speed is reduced. Suckers will also still fire their shots when they die. An attack fly that has newly spawned will still need to 'convert' into a simple black fly, and touching it will damage you.

Final reward for Shell game in Arcade.

Isaac supports a pile of poo on his head.

Skeleton Key

Found in the Item Rooms and Challenge Rooms.

A keyhole appears on the player's forehead.

Small Rock

Increases damage by 2, decreases speed by 1 , and turns tears grey.

Found in X Rocks.

Unlocked by bombing 50 rocks.

Isaac has a rock wedged into his head.

Spelunker Hat

Unlocked by completing the Caves.

Isaac wears a miner's helmet.

Spider's Bite

Note: This will work against statues in The Depths and against Knights from the front.

This item will only appear in a Secret room.

Unlocked by completing the Basement.

Isaac has a red "bite mark" on his head.

Spoon Bender

Note: This does affect Technology visually, but has no actual effect.

Isaac gets a flaming, psychic third eye.

Steam Sale

Reduces all Shop prices by 50%, rounded down (in the case of collectable or activated items) or rounded up (in all other cases). Will affect items that were already on sale before obtaining this item.

Occasionally dropped by Greed or the Judgement card and can be bought in Shops.

Isaac gets a price tag.

Steven

If you already have Little Steve and you fight the special Steven boss, he will drop this instead. There is also a chance to get Steven without Little Steve if you kill the "little steve part" of the boss first''.

Using the D6 in the Boss Room with Little Steve can give Steven, and vice versa.

Trivia: A cameo from another of Edmund's game, Time @#!*% .

Dropped by Steven. Can also be found rarely in golden chests (Even before unlocking him as a boss).

Isaac gains a little "Tumor" buddie.

Super Bandage

Trivia: This is a reference to "Bandage Girl" from Super Meat Boy, another game Edmund McMillian worked on.

Rarely Found in Boss Rooms.

Unlocked by killing four Horsemen in one playthrough.

Isaac gets things like a bandage and a flower. Resembling Bandage Girl.

Technology

If you have Technology and Dr Fetus at the same time, you will fire both a bomb and laser simultaneously.

Shots can still be charged with Chocolate Milk, which makes them stronger and visually wider.

Brimstone has priority over Technology. If you already have Brimstone, picking Technology will have no effect. If Brimstone is taken after Technology, it will override it.

If A Lump of Coal is picked up after technology, damage is increased. (Maxed?)

Creates a wobbly beam when used in tandem with the Wiggle Worm. This increases the beam's width slightly.

Isaac gets a cyborg eye.

Transcendence

If you have an upgrade which makes your player's body look demonic (like The Pact or The Nail), Transcendence will give you black demon wings instead of simply removing the character's body. This happens regardless of whether the demonic item is acquired before or after Transcendence.

Bug: Allows the player to go into Challenge Rooms without being at full health, and allows the player to leave before the gate is reopened as well.

This item appears only in Secret rooms.

Unlocked by completing the game twice.

Isaac becomes a floating head.

Treasure Map

Reveals all rooms for every floor, including the Secret Room. However, it does not reveal icons.

If you only have The Compass and see a mini-boss icon, you are sure to meet Greed there if you collect the map and it shows the secret room at this point.

Common in Shops and occasionally found in Challenge Rooms. Often given by Beggars.

The Virus

Gives the player the ability to deal damage to, and poison, enemies they touch for 2.5 seconds. The player will still take damage from touching enemies, but remember that not every enemy can hurt you by touch!

Small black flies (not the flashing ones) can be killed by running into them without taking damage.

This item is sometimes dropped by Lust, or found in the Challenge Room.

Isaac becomes diseased.

The Wafer

Reduces all damage received by half, rounding up to the nearest half-heart. This includes the damage received from using a Blood Donation Machine in The Womb.

Works wonders with ???: All items in the 'Devil Room can be bought with 1/2 soul heart. However, this no longer works.

Unlocked by completing the game 7 times.

Isaac starts glowing around his head.

Whore of Babylon

Note: If ??? picks this up, he permanently gains its effects upon leaving the room for the remainder of the game.

Bug: Avoid buying it while having plenty of soul hearts and only one red as it will leave you with no hearts at all and you'll die on first hit.

*Note that Edmund'McMillen (the creator) has said that Whore of Babylon and similar items are damage multipliers. Source: http://www.youtube.com/user/Northernlion#p/u/5/i2cN4DkEQEE*

Trivia: The pop-up message when activated is a reference to the NES game "Castlevania 2: Simon's Quest" when nightfall comes.

Eve starts the game with this item.

Found in the Devil Room, Item Room or after defeating The Fallen. Might appear in the shop for 2 hearts instead of coins as well.

Isaac becomes a spawn of Satan.

Wiggle Worm

Gives the player waving shots and increases attack speed by 1; these do not angle with movement.

Note: Good interaction with Mom's knife; if thrown correctly it hits multiple times before returning.

Good interaction with Technology, as it will cause the beam to snake, increasing its area of effect.

Found in the Shop or Item Room.

Isaac's eyes shrink and become jittery.

Wiggle Worm + Technology - different wavelengths:

Wired Coat Hanger

Increases Tears by 2 (Rate of fire).

Found in the Boss Room.

Isaac gets a coat hanger through his head.

Wooden Spoon

Found in the Boss Room.

Isaac has beat marks from a spoon.

X-Ray Vision

Trivia: The effect is described as "I've Seen Everything," a reference to Patrick Stewart's appearance on British sitcom "Extras" alongside Ricky Gervais.

Note: This can create exits from the Secret Room that are normally not possible, such as exiting into a Boss Room.

This item can be exploited to indefinitely recharge items with the Battery by entering and leaving a room with enemies without clearing it as needed.

Isaac wears x-ray glasses.

Item Icon

Item Name

Effect

When damage is taken, these are used up before regular hearts.

Used to blow up an obstacle: rocks, poop, fire, closed doors, and walls to create an entrance to the Secret Room.