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Items are an integral part of gameplay in The Binding of Isaac. They modify a character's stats, grant or modify abilities, among many other things. There are 198 different items in the game. Below is a list of all of the items, separated into categories. Certain items change the appearance of your character when they are acquired. Items you've found can be seen in the Collection page.

Caution - Please remember that the game saves on a timer, and also saves when you use the in-game exit command. It is possible to lose unlocked items, bosses, statistics and so on if the program is improperly closed without a chance to save.

Note: Please keep discussion of what items are better than what out of the tables. Use the Item Discussion page for that.

Item Demonstrations

Videos of items in use can be found by clicking on the Movie strip link in the info section for that particular item. Note that these are external links and will navigate away from the wiki.

Acquiring Items

The main ways of obtaining items are by entering Treasure Rooms and defeating Bosses. Items can also be purchased from Shops, found from Beggars, obtained by making deals with the devil, found in a Secret Room, dropped by standard enemies, and collected through other, less evident means, such as blowing up a Tinted Rock or opening a golden chest. It is possible to acquire activated/collectible items in the Challenge and "I AM ERROR" rooms. There are also five specific items you can get in the Arcade: Skatole from the shell game, either the blood bag or the IV Bag from the Blood Donation Machine, and either The Dollar from the Slot Machine or Crystal Ball from the Fortune Teller Machine, whichever happens to be in the arcade

Note 2: It is possible to "pick up" an item you didn't intend in the Boss Room with the trapdoor. If you have a high speed and walk into the trapdoor in the direction of the item, you will show as dropping into the trapdoor but your familiars will fly on ahead as if you were still moving. If they come near the item, it's possible it may get picked up.

Note 3: All characters (except for Isaac, until the D6 is unlocked) will start out with items.

Activated Items

Main article: Activated Items

These items are stored in the Spacebar slot and are used up once the button is pressed. The items then recharge in one of two ways. Normally, they charge a number of bars after every room you clear -- some items charge one bar at a time, others charge faster. Note that only rooms where the doors close until they are cleared count -- Bosses, arenas, enemy rooms, etc. The Collectible Item "Battery" can give bars of charge during combat, on top of the normal recharge. Another Collectible Item, the "9 Volt" will automatically recharge 2 bars when an item is used; this effectively reduces the number of rooms required to charge an item if the item requires 3 or more rooms to charge. In the Wrath of the Lamb DLC, there is another item, the Habit, which will recharge bars when taking damage. To see a clearer version of the in-game arrangement go to the Collection page.

Note: You can only hold one of these at a time.

Additional Note: Any two of the same activated item on the same floor will share charge state, i.e. finding another of the same activated item' when one is not fully charged' will not give the player another fully charged version of the item.

Item Effect Info Rooms to Recharge Collection Grid


Anarchist Cookbook

File:Anarchist cookbook.png

Spawns six troll bombs around the room.

Frequently dropped by Pride.

The Tower tarot card has the same effect.



The Bean


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

(Same as the Bad Gas pill)

Unlocked by destroying 50 poop piles.

Movie strip



Bob's Rotten Head

File:Bob head.png

Throws a bomb in the direction Isaac's facing. It does extreme damage, poisons the enemy for 5 seconds, and destroys rocks. Bombs will arc back towards Isaac with the My Reflection upgrade.

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

Bug: Having Brimstone and attempting to use Bob's Rotten Head causes you to get stuck.

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

Bug: Having Technology 2 renders you unable to throw Bob's Rotten Head.

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



The Bible

File:The Bible.png

Transforms Isaac into an angel, allowing him or her to fly over obstacles for the current room only.

Isaac Fate

Instantly kills Mom, Mom's Heart, and It Lives.

Satan or Isaac will instantly kill you for using it, even after death (unless you have The Wafer).



The Book Of Belial


Doubles damage until you exit the room, just like The Devil tarot card. It also gives Isaac an angry face with empty eye sockets with blood running down his face until he exits the room.


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

Movie strip



Book Of Revelations


Adds 1 Soul Heart.

Using the book will ensure you meet a Harbinger as the level boss, if possible.

May also cause you to fight the Headless Horseman in Sheol instead of the final battle with Satan.

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



Book Of Shadows

File:Book of Shadows.png

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


(Fixed) Greed, Avarice and Hangman still knock out your coins if you get hit by shots fired by them.

This cannot be used to get items from the devil room without paying.

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

This item can be found in the library, the item room and the shop.

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

Movie strip



The Book Of Sin


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

Unlocked by beating each of the Seven Deadly Sins.

Can be obtained in the devil room.



Dead Sea Scrolls


Uses a random Activated Item (even locked ones).

If the item mimicked has no recharge time (Kamikaze! for example), the scrolls can be used again immediately with no recharge period.

Beware; this item may harm the player if the effect mimicked can do so.

Sometimes causes zombies to "moonwalk" when used.

Movie strip



Deck of Cards


Gives Isaac a random tarot card.

The card spawns in the player's inventory. This will cause the player to drop the currently held Q - slot item when used.





Re-roll all activated and collectable items on screen.

It can also be used to change shop merchandise or boss drops. The exception is with special drops from alternative 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.

The D6 re-rolls items from the same pool, eg. a secret room reroll will only yield another secret room item.

It is possible to obtain items only unlockable through achievements using the D6 without having completed the achievement.

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 undefined. See the bugs section for more information.

Unlocked by completing The Womb with ???.

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

Movie strip



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.

Pressing space at any time during the targetting phase will launch the missile at the target.

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

The missile acts like a huge bomb explosion.

Movie strip



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 ???.



The Gamekid


Isaac turns into a Pac-man-like creature, gaining invincibility, the ability to damage enemies on touch, and causes enemies to run away for 5 seconds. Heals 1/2 heart for every 2 enemies killed while in use.


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

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. It will also sometimes visibly move your head until you leave the room. (Probably in combination with Technology, but not confirmed.)

Does not work on the Masks of Evil enemy, even while chomping the hearts. (bug?)

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 icon is a reference to the Nintendo Gameboy, one of the first portable gaming systems, the transformation a reference to Pac-Man.

Unlocked by visiting arcades 10 times.

Movie strip



The Hourglass


Slows enemies and enemy projectiles for 7.5 seconds.

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

Movie strip





Causes an explosion in the same area as Isaac, causing one heart of damage, but also damaging monsters caught in the blast.


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

Can be used multiple times without losing any hearts while under the invincibility effects of the Chariot card.

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

Movie strip



Lemon Mishap


Causes Isaac to have an accident, creating a pool which damages anything that crosses it (except for the player).

Flying enemies are not damaged by the pool.

Similar to Peep's ability.

Movie strip



Mom's Bottle of Pills

File:Mom's Bottle of Pills.png

Spawns a random pill near Isaac.

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

The pill spawns in the player's inventory. This will cause the player to drop the currently held Q - slot item when used.

Unlocked by using a Blood Donation Machine 20 times.

Movie strip



Mom's Bra


Causes Isaac 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 it may cause a bug that makes winning impossible. See the bugs section.

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



Mom's Pad

File:Moms pad.png

Causes enemies to back away from Isaac for 5 seconds.

Bug: If used against stationary bosses like Gurdy, they will slide away, but recenter after its duration ends.

Movie strip



Monster Manuel

File:Manuel IT.png

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

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



Monstro's Tooth

File:Monstros tooth.png

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.

Monstro can be damaged when he appears on screen and can be killed if you freeze him or he gets caught in Satan's laser attack, but drops nothing on death.

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.



Mr. Boom

File:Mr Bomb.png

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.



My Little Unicorn

File:My Little Unicorn.png

Grants Isaac temporary invincibility while damaging enemies by touch.


Trivia: This item's name is a reference to "My Little Pony", a popular television show featuring unicorns and magic. Isaac won't fire unless he's holding Mom's Knife. Familiars will attack as normal.

Bug: You will still lose coins from touching Super Greed while this item is activated.

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

Movie strip



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.

Ss (2012-07-04 at 05.37.38)

Unlocked by completing game 3 times. Available in the Devil Room (or as a possible drop from The Fallen). Also appears in the Curse Room and can be given by the Demon Beggar if you have the Wrath of the Lamb DLC.



The Necronomicon


Damages all enemies in the room significantly.

Unlocked by using the Death Tarot Card 4 times.

It will also destroy all enemy shots on the screen at the time you use it.

Movie strip



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.

Official pony

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.

If spacebar is pressed but directional buttons are not, your character will become permanently invincible and will deal damage to all enemies that touch.

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



The Poop


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

Will block enemies' movement and attacks.

As with regular poop, destroying it may yield coins or hearts.

Unlocked after 10th playthrough.

??? starts the game with this item.

A strategy for this item is to use it to block out enemies shots, since it will act as a shield.

When used while being on a spider web, poop does not appear.

Movie strip



Razor Blade

File:RaZoR IT.png

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

Eve Razor Blade small

Eve before and after using the Razor Blade.

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.

Bug: Will cause death if it removes the last whole remaining heart container, even if Soul Hearts remain.

Movie strip



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).


Unlocked by dying 100 times.

Found in Shops and the Item Room. Also spawned by The Dead Sea Scrolls.

When used in conjunction with Habit, it is possible to have multiple copies of Isaac's body all attacking enemies.

(If you are using an item that makes Isaac Black, such as Lord of the Pit, the body will also be Black.)



Shoop Da Whoop!

File:Shoop Da Whoop.png

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.

Movie strip



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.

More commonly found in Chests than anywhere else.

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





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.

Movie strip



We Need To Go Deeper

File:We need to go deeper.png

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.

Cannot be used to skip from Cathedral to the Chest, even if you have the Polaroid.



Yum Heart

File:Yum heart.png

Restores 1 whole heart.

Unlocked by having seven heart containers.

Useless with "???"

Magdalene starts the game with this item.

Movie strip



Wrath of the Lamb Activated Items

The following activated items can only be acquired in the Wrath of the Lamb DLC.

Item Effect Info Rooms to Recharge Collection Grid


Best Friend

File:Best friend.png

Deploys a decoy Isaac that eventually explodes.

The explosion can hurt Isaac if they are within the blast radius.

High chance of getting eaten by Chub like regular bombs.

Orbiting items such as meat cube and sacrificial dagger will be transferred to the doll when activated.

If you have Distant Admiration, Forever Alone, or other type of follower fly when you use this item the flies will follow the decoy until it explodes.

Bug: If you activate Best Friend while you have the Sister Maggy familiar, Sister Maggy will turn into Ghost Baby until the decoy explodes, after which it will revert back to Sister Maggy immediately.

Bug: After activated, if the doll is hit by The Fallen's cross blood beam, it will count as you died. May occur with other attacks.

3 (B,6,3)

Blood Rights


Consumes HP to damage all enemies in the room.

Unlocked by defeating Satan as Samson.

Makes blood pour from the walls.

Like Necronomicon, destroys Masks of Evil without killing their hearts.

0 (B,6,8)

The Candle


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

Recharges itself.

Unlocked by completing Challenge 1.

Recharges in about 3 seconds, even faster with The Battery.

The flames can damage Mom when fired at any of the four doors in the room, even when they are closed and It Lives when it is hidden from view, simply by firing into the centre of the room.

The flames can damage Satan's second form when used on the statue present when fighting his first form (The Fallen). The statue will flash red upon taking damage and Satan's second form will start with health missing.

Evaporates enemy shots.

Possible reference to the "Candle" item from The Legend of Zelda.

It will often be available for purchase in the store.

0 (B,4,6)

Crack The Sky

Crack The Sky Icon

Calls heavenly beams of light to fall upon your enemies dealing mass damage to whatever they hit.

Random attack pattern.

Movie strip

4 (B,10,5)

Crystal Ball

File:Crystal ball.png

Reveals the map and gives a random card or soul heart.

Found from a fortune telling machine.

It is possible to already have a Crystal Ball while finding another one in a fortune telling machine. In this case, the charge levels of both balls will be the same.

6 (B,8,5)


D 20

Randomly changes all Pickups in the room.

This includes undetonated troll bombs, trinkets, and chests - even empty ones that would despawn after leaving the room. This includes the Troll Bombs dropped by War and Pride.

Unlocked by completing the Cathedral as Isaac.

Found in the Item Room.

Does NOT reroll Item Room items, Challenge Room Items, Shop Items, or Devil Room / God Room items.

Movie strip

6 (B,6,6)

Dad's Key

File:Dads key.png

Unlocks all normal doors in room when used. Allows the player to exit a fight.

Can unlock Devil's Room during a Boss Fight.

Can be used to escape a Challenge Room

Unlocked by beating the boss in The Chest.

Found in the Secret Room and the Item Room.

2 (B,5,7)

Guppy's Head

Guppys Head Icon

Spawns 2-4 Blue Flies to damage enemies. Flies won't spawn if entering a door while using it.

Found in Devil Room for 2 hearts, Red Chests, Challenge Room or as a drop from fight with The Fallen.

If you collect any three of the Guppy's items (Guppy's Head, Guppy's Tail, Guppy's Paw, Dead Cat), Isaac will becomes Guppy. If it's Guppy's Paw or Guppy's Head, you only need to use it once (you can drop it afterward) to make the game counts you as "carrying" the item.

Movie strip

1 (B,5,4)

Guppy's Paw

File:Guppys paw.png

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

Does nothing for ???.

Found in Curse Rooms, Devil Rooms and from bosses.

Can be used again instantly after use providing there is at least one heart container left.

If the player uses a Strength tarot card, they may exchange the temporary heart container for 3 spirit hearts.

One of the four items that will turn you into Guppy if you collect any three of them. Check Guppy's Head for the details.



IV Bag

File:Iv bag.png

Exchanges hearts for coins.

Can be activated during post damage invulnerability for free coins. If timed properly, it can be activated 3 times in a row while under post damage invulnerability to generate coins for the cost of 1 activation.

Works well with Bloody Penny.

Portable Blood Donation Machine.

Reward from Blood Donation Machine.

The health cost of using IV Bag is equal to the health cost of the Blood Donation Machine it came from.

If the Book of Shadows is activated before picking up the IV bag, you can spam the IV bag for about 20-30 coins before the shield wears off.

When used, if immediately used afterwards, you can get another use of the IV bag for the cost of half a heart.

0 (B,5,3)

Notched Axe


Breaks a single rock when activated. Can also be activated again to put away the pickaxe if you haven't used it.

Will destroy rocks, poop and extinguish fires.

Found in the Item Room and in the Shop.

Reference to Minecraft creator Markus "Notch" Persson, as well as the Minecraft item "Iron Pickaxe".

1 (B,7,4)

Prayer Card

File:Prayer Card.png

Grants half an Eternal Heart per use.

Completing an Eternal Heart (i.e. getting two halfs) or having half an Eternal Heart when you progress to the next floor will convert it to a full Heart Container.

Works well with ???.

Found in the Item Room, Shop and Angel Room.

6 (B,6,4)

Portable Slot

File:Portable Slot.png

Same effect as the Slot Machine.

Costs 1 coin to use.

Found in the Item Room, Shop and golden chests. Can also be dropped by the Devil Beggar.

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Remote Detonator

Remote Detonator Icon

Bombs you place explode only when you use this item.

Gives 5 bombs.

Also destroys T.N.T. on use.

Fetus bombs will detonate on their own but can also be detonated earlier. Also works on Wrath's bombs.

Has no cooldown.

Movie strip

0 (B,7,3)

Spider Butt


Damages all enemies in the room and inflicts slowdown condition like Spider's Bite.

Found in the Item Room.

Unlocked by completing Challenge 8.

2 (B,1,7)

Telepathy For Dummies


Tears track targets for one room. Same effect as Spoon Bender.

Found in the Library Room and Item Room.

Movie strip

2 (B,2,9)

White Pony


Increases speed by 2 and allows Isaac to fly while equipped.

Upon use Isaac will charge in the direction selected and deals damage to monsters. In addition, when used it also has the Crack the Sky effect.

While carrying this item, may cause the Headless Horseman to ride a White Pony.

Found after defeating Conquest.

6 (B,1,8)

Collectible Items

These items generally give you some kind of a boost to your stats, or add a special passive ability. They take effect immediately once picked up, and continue for the rest of the game (except for several items that do not provide any lasting effect).

Edmund McMillen split them up in his blog into the subcategories weapon item, stat padding items, passive items, and familiars.

Name and Icon Effect Info Collection Grid (Pg,X,-Y)



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 Item Rooms.

File:Greater Than Three.jpg

Attaches a beating heart to Isaac's chin.



File:1 up.png

Gives Isaac 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 a 1UP while doing a deadly trade with the devil, or dying at any other time when you have no normal heart containers, 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.

Only appears in Secret Rooms.


Familiar: Follows the player.


9 Volt


Leaves Isaac with two bars already charged after using an item.

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

This item is most common in shops.

File:Nine Volt Isaac.jpg

Makes a battery appear smashed into Isaac's head.


The Battery


Gives Isaac 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 can be dropped by beggars.

File:Battery Isaac.jpg

Makes Isaac have Frankenstein bolts on his neck.

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The Belt


Increases Speed by 2.

Found in the Boss Room or in the Item Room.

File:The belt.jpg

Gives Isaac a belt.

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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.

File:Blood Bag Isaac.jpg

Makes Isaac have a blood stained face.


Blood Of The Martyr


Increases Damage by 2, turns Isaac's tears into blood tears.

Found in the Item Room, Angel Room or Curse Room.

File:Blood of the martyr.jpg

Isaac gains a crown of thorns.




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.

No visual effect.

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Bomb Bag

File:Bag of Bombs IT.png

Isaac 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.

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File:Boom big.png

Gives 10 bombs.

Found in the Item Room or Challenge Rooms.

File:Boom! isaac.jpg

Adds a lit fuse to Isaac's head.




Increases HP by 1.

Found in the Boss Room and can be dropped by the Beggar.

No visual effect. (A,7,3)



Changes tears to a chargable 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)

Note: 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. As of v1.48, this appears to have been changed. If you begin charging Brimstone while firing, the shot will be cancelled.

Using it with Chocolate Milk allows Isaac 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. Also, Chocolate Milk drastically reduces the overall damage of Brimstone, even when fully charged.

When used with The Innter 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 your Tears stat reduces charge up time of Brimstone.

Increasing your damage stat 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 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.

Technology 2 still fires a laser if Brimstone was acquired after Technology 2. This may be a glitch, as the laser is thin, flickers and appears to go "backwards" a bit as well as forwards. It will still deal damage, however.

If you obtain technology 2 after brimstone, it will typically work the same as getting brimstone first, but without the flickering. The exception is when using Cain, in which case brimstone will cease to shoot and instead technology 2 will fire at all times and deal immense damage. (Needs confirmation for Cain)

For Cain, if Technology 2 was obtained first, the Brimstone laser will charge but not fire. There is also a delay created when attempting to turn. Technology 2 does damage as it normally would.

If you obtain Brimstone after getting the Dead Dove, Isaac will take the form of Lord of the Pit but shoot the Brimstone laser

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

As of 1.3, attempting to recharge the laser while it is firing will stop the laser, preventing it from firing or causing it to do less damage.

Available in Devil Room for 1 or 2 hearts or as a reward after fighting The Fallen. Also may be given as a gift from the Devil Beggar.

Brimstone Isaac

Isaac appears demonic.


Brother Bobby


Follows Isaac around shooting normal tears.

Found in the Item Room or in the Devil Room. Can also be a reward from the Devil Beggar.

Brother Bobby

Familiar: Follows the player.

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Bucket Of Lard

File:Bucket Of Lard.png

Gives two empty heart containers, heals by half a heart but decreases speed by 1.

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


Isaac appears significantly fatter than usual.

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Charm Of The Vampire

File:Charm of the Vampire .png

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 ???.

Charm of the Vampire

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


Chocolate Milk

File:Chocolate Milk.png

Allows Isaac 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.

File:Choco milk.jpg

Cheeks inflate while shots are charged.


The Common Cold


Gives Isaac'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.

Common Cold Isaac

Isaac gets sick. Instead of crying, Isaac will now spit green projectiles.



The Compass

File:The Compass.png

Shows the icons of special rooms (Item room, Boss room, the Shop, the Arcade, Mini-boss room) on the map without revealing rooms.

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.

No visual effect. (A,3,3)

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 provide another floating cube (so in theory after collecting an 8th Cube of Meat, the player would have two lvl 4 Meat Boys. The bug where a 5th cube would create a "headless boy" instead was fixed, as seen in this video.)

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.

Bug: On the second pick up when entering a room it will turn into brother bobby for a split second

Unlocked by completing The Depths.

Meat Cube Isaac

Meat1boy > Meat2boy >

M3atboy > Meat4boy

{C}Level 1 - 2: Orbit: Circles around the player At level 2, it shoots blood.

Level 3 - 4: Familiar: Follows the player.


Cupid's Arrow


Gives Isaac 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.

Cupid&#039;s Arrow Isaac

Isaac wears a Native-American headdress.


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Dead Bird

File:Dead Bird.png

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.

Sprite is from an earlier game titled "AVGM", which is another game by Edward McMillen.

File:Dead Bird Isaac.jpg

Familiar: Follows the player after activation.

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

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Dead Cat

File:Dead Cat.png

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. ???'s health will be set to soul heart. If you have no health at all you will get 1 heart container that is filled half). 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.

When you get additional heart containers your heart containers will reset to 1 after your first death.


Familiar: Follows the player.




Increases available heart containers by 1.

Found in the Boss Room.

No visual effect. (A,6,3)



Increases available heart containers by 1.

Found in the Boss Room.

No visual effect. (A,5,3)

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.

Red Attack Fly

Orbit: Circles around the player.

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Demon Baby

File:FFS Demon Baby.png

Follows Isaac 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 none in range. Does not shoot across holes in its range.

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.


Familiar: Follows the player.


A Dollar


Sets your penny counter to 99.

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 (rarely).

Automatically unlocks Cain.

No visual effect. (A,9,2)

Dr Fetus

File:Fetus in a jar.png

Replaces Isaac'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.

With Spider's Bite, bombs gain slowing effect and bombs will flash red and yellow.

In the Wrath Of The Lamb, when combined with Mr.Mega the bombs gains the huge troll bomb look.

Substantially increases the likelihood of bomb-related upgrades.

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

Epic Fetus has priority over Fetus in a Jar.

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

The Common Cold makes the bombs fired green but no poison effect is added to the bombs.

Unlocked by completing the game 5 times.

A rare find in the Item Room.

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

With the Lump Of Coal, the bombs turn completely black.

With Spoon Bender, bombs turns purple.

With the Parasite, the bombs turn reddish-brown.

File:Dr Fetus.jpg

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


Forever Alone

File:Forever Alone Fly.png

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

Doesn't deal as much damage as Distant Admiration.

Blue Attack Fly

Orbit: Circles around the player.

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Guardian Angel

File:Guardian Angel IT.png

Spawns a guardian angel that orbits Isaac. Does damage on touch similar to other orbitals.

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 and Angel Room.

File:Guardian Angel.png

Orbit: Circles around the player.


Growth Hormones

Growth Hormones

Increase Speed and Damage by 2 each.

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

File:Growth Hormones.jpg

Issac receives inhuman growths on his head.

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The Halo


Increases all stats except range by one.

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

Found most common in the Item Room.

File:Halo Isaac.jpg

Isaac sports a halo.

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Halo Of Flies


Grants 2 Flies that circle Isaac, 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.

File:Halo of flies.jpg

Orbit: Circles around the player.

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The Inner Eye


Gives Isaac 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.

File:Inner Eye.jpg

Isaac gains a third eye.



The Ladder


Allows Isaac to walk across gaps one square across by automatically placing a ladder between the two walkable areas (or between walkable area and room wall).

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.

Note that this item is only useful in levels from 3 to 6 as later levels do not have pits.

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.

Isaac The Ladder Small

No visual effect on the character, but the ladder appears beneath them when crossing gaps.


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, Sister Maggy or Little Gish at the time of collecting Little C.H.A.D., Little Steve/Sister Maggy/Little Gish will be transformed into Brother Bobby for the duration of the room.

Unlocked by killing the alternate boss C.H.A.D.


Familiar: Follows the player.


Little Chubby

Little Chubby Icon

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.

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.


Familiar: Follows the player.


Little Gish

File:Little gish.png

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.

Familiar: Follows the player.


Little Steve


Follows Isaac around shooting homing projectiles

The D6 CAN be used after the boss fight with the alternate boss Steve to give Steven instead of Little Steve, and vice versa. However the drop rate of Steven from Steve is very low, re-rolling most likely gives you Little Steve again.

Unlocked by killing the Steve alternate boss and is dropped after the boss fight. Can also be found in item rooms.

Bug: Little Steve might turn into Brother Bobby in every new room until you get harmed.


Familiar: Follows the player.

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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.

Lokii Horns Isaac

Isaac gains small horns.


Lord Of The Pit


Isaac 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.

Can be found in the Devil Room and after fighting The Fallen.

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".)

File:Lord Of The Pit Isaac.jpg

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.

As of WOTL version 1.48, it reduces the chance of getting random fortunes from the Fortune Telling Machine, and increases the chance of getting rewards from it.

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.

File:Lucky Foot Isaac.jpg

Creates a gold anklet on Isaac's left foot.




Increases available heart containers by 1.

Found in Boss Rooms, and can be obtained from Beggars.

No visual effect. (A,4,3)

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.

File:Isaac Lump of Coal.png

Coal dust on forehead. Tears are stained black.


Magic Mushroom

File:Magic mushroom.png

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

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

A reference to Super Mario Bros.

File:Magic Mush Isaac.jpg

Player becomes visually larger.




Attracts coins, bombs, hearts and keys towards Isaac from a set distance (about 7-8 spaces). Objects can cross pits, spikes, and rocks. Will not draw in hearts if HP is full.

Note: It will also attract troll bombs towards Isaac.

Magneto will only attract eternal hearts when health is not full (Like red hearts).

File:Magneto Isaac.jpg

Isaac has a magnet on his head.

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The Mark

File:The mark.png

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.

Also found in Curse room.

File:The Mark Isaac.jpg

Isaac sports three 6's in a circular pattern.


Max's Head


Increases damage by 1, increases the size of tears and causes tears to inflict more knockback on enemies.

Note: Even though it only appears to increase damage by 1, a single tear will kill attack flies, and kill Pooters and Horfs in two hits.

File:Max's Head Isaac.jpg

Isaac's eyes grow bigger and more shiny.


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Mini Mushroom


Increases speed and range by 1.

Shrinks Isaac's hitbox, making dodges easier.

File:Mini Mush Isaac.jpg

The player's size decreases.

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Mom's Contacts


Gives Isaac 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.

File:Mom's Contacts Isaac.jpg

Isaac gains a red eye.


Mom's Eye

File:Moms Eyes.png

Increases Tears stat and gives Isaac an eye on the back of his head, allowing you to shoot in both directions at the same time.

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.

Mom&#039;s Eye

Isaac gets another eye on the back of his head.

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Mom's Heels


Increases Range by 2.

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

File:Mom's heels.jpg

Isaac wears mom's shoes.


Mom's Knife

File:Moms Knife.png

Once collected, Isaac no longer shoots tears, he shoots the knife from his mouth boomerang style. The range of throw increases by charging the shot. It can also be shot diagonally by using two arrow keys. Mom's Knife passes through enemies on its arc.

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).

Finding Dr Fetus after Mom's Knife will replace the knife with the Dr. Fetus effect.

Finding Epic Fetus after Mom's Knife will give you the knife's effect for the current room, and when you leave the room you get the Epic Fetus effect.

When you combine Mom's Knife and Technology 2 you will have both the beam and the knife, but the knife is the only one that damages.

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.

When using 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.

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

When the Candle is used with a Wiggle Worm Knife, the Knife stalls in the air when thrown or used when walking.

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.

if the player has choclate milk, the knife will become extremly powerful and will kill most bosses with one hit (even mom, It Lives/moms heart and satan)

Using the mouse to attack will not allow you to shoot diagonally.

Unlocked by beating Sheol with Isaac.

File:Mom's Knife Isaac.jpg

Isaac wields mom's knife and wears her dress.


Mom's Lipstick


Increases Range by 1.

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

File:Mom's Lipstick.jpg

Isaac wears mom's lipstick sloppily.


Mom's Underwear


Increases Range by 1.

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

File:Mom's Undies.jpg

Isaac wears Mom's panties.


Money = Power


Increases damage based on the number of coins the player has at the moment. (10 coins = 1 extra damage).

Found in the Item Room or Devil Room.

Unlocked by completing the game 8 times.

File:Money Equals Power Isaac.jpg

Isaac gets pimpin' glasses.

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Mr. Mega


Gives Isaac 5 bombs, and makes all dropped bombs large bombs (the same sized bomb dropped when Mr. Boom is used). Increases the damage of bomb, noticeable in boss fight.

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, and shops

File:Mr Mega Isaac.jpg

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

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My Reflection


Gives Isaac'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.

Bad in conjunction with Ipecac.

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

File:My Reflection.jpg

Isaac gains a Sailor Moon type symbol on his forehead.


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Number One


Sets Isaac's tears to their maximum rate of fire and minimum range.

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.

File:Number one!.jpg

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


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Odd Mushroom (Thin)


Increases speed by 1, increases Tears to maximum (Rate of fire) while reducing projectile damage by 1.

Found in the Item Room and Shops.

File:Odd mush thin.jpg

Makes player's head smaller.

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Odd Mushroom (Large)


Increases damage by 1, and increases maximum hearts by 1 while reducing speed.

Found in the Item Room and Shops.

File:Odd Mush Flat Isaac.jpg

Makes player's head bigger.

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Ouija Board

File:Ouija Board.png

Allows Isaac's shots to go through rocks or obstacles, but unlike other piercing upgrades will not pierce enemies and will not damage Knights from the front.

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

Tears go through fire, poop, 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 the Devil Room, Item Room or from Beggars.

File:Ouija Isaac.jpg

Makes Isaac's head look undead or soulless.


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The Pact


Increases Damage by 1 and rate of fire by 2. 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.

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

File:The Pact Isaac.jpg

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


The Parasite


Makes the Isaac'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/Brimstone) 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.

Does NOT split bombs when used in conjunction with Dr. Fetus. It only changes the color of the bomb to orange and the explosion turns orange as well.

File:Parasite isaac.jpg

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





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

Found in the Boss Room.

File:Pentagram Isaac.jpg

Isaac grows large horns.




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.

File:PHD Isaac.jpg

Isaac wears a doctor's mask.

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A Quarter


Gives you 25 pennies.

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.

No visual effect. (A,10,2)

Raw Liver

File:Raw Livercrop.png

Increases available heart containers by 2 and completely restores health. Reduces range by 1.

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

No visual effect.

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The Relic

File:The relic.png

Isaac is followed by a small blue cross that will drop a Soul Heart upon completion of every fourth room.

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 Womb with Magdalene.


Familiar: Follows the player.

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

bug: when the Robo-baby shooting his laser in the same time with 'monstro II beam it 'change laser to vary large but same damage

Unlocked by completing The Womb with Judas.


Familiar: Follows the player.


Roid Rage


Increases Speed and Range significantly.

Found in Challenge Rooms, Item Room and Shop.

Trivia: This item's name, appearence and effect are taken from 'an item from The C Word, another of Edmund McMillen's games.

File:Roid Rage Isaac.jpg

Isaac gets crazy looking.

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Increases Faith by adding 3 Soul Hearts and increases the chance for a Bible to appear in the subsequent levels of the playthrough.

Found in Item Room and Shop.

File:Rosary Isaac.jpg

Isaac has a cross amulet.


Rotten Meat


Increases available heart containers by 1.

Found in the Boss Room and gold locked chests.

No visual effect. (A,8,3)

Sack Of Pennies


Isaac is followed by a small bag that drops a coin upon completion of every two rooms. Usually a penny, sometimes a nickel.

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 completing The Womb with Cain.

Familiar: Follows the player.


The Sad Onion

The Sad Onion Icon

Doubles the Tears Stat (Rate of fire).

More commonly found in Chests. Trivia: Possibly a reference to a running gag from Ashens' videos.

File:Sad onion.jpg

Isaac begins to cry much harder.


Sister Maggy


Follows Isaac around shooting blood tears.

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

Sister maggy

Familiar: Follows the player.




All the various fly type enemies no longer harm you, shoot, or split.

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.

File:Skatole Isaac.jpg

Isaac supports a pile of poo on his head.


Skeleton Key

File:Skeleton Key big.png

Sets your key count to the maximum of 99.

Found in the Item Rooms and Challenge Rooms.

File:Skele Key Isaac.jpg

A keyhole appears on the player's forehead.

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Small Rock

File:Small rock.png

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

Found in X Rocks.

Unlocked by bombing 50 rocks.

File:Small Rock Isaac.jpg

Isaac has a rock wedged into his head.

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Spelunker Hat


Reveals the Secret Room and Top Secret Room when passing by it and reveals if a room contains a mini-boss.

Unlocked by completing the Caves.

File:Spelunker Isaac.jpg

Isaac wears a miner's helmet.


Spider's Bite

File:Spiders Bite.png

Gives Isaac's shots a chance of slowing enemies for 2.5 seconds. The projectiles from a slowed enemy are also slowed but retain their air time, effectively reducing their range. Turns tears white.

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

This item will only appear in a Secret Room.

If used with Brimstone the laser will slow enemies.

Unlocked by completing the Basement .

File:Spider bite.jpg

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



Spoon Bender


Gives the Isaacs's shots the ability to curve towards enemies and turns tears purple.

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

File:Spoon Bender Isaac.jpg

Isaac gets a flaming, psychic third eye.



Steam Sale

File:Steam Sale.png

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.

File:Steam Sale Isaac.jpg

Isaac gets a price tag.




Increases Damage by 2.

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.

Using the D6 with Little Steve after Steven boss fight will have a small chance to change it to Steven.

Trivia: A cameo from another of Edmund's game, Time Fcuk.

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

File:Steven Isaac.jpg

Isaac gains a little tumor buddy.


Super Bandage


Increases HP by 1 and gives 2 soul hearts.

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

Rarely found in Boss Rooms.

Also makes a unique sound on pickup.

Unlocked by beating 4 horsemen in boss rooms in one playthrough.

File:Super bandage.jpg

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




Gives Isaac a laser shot with unlimited range. Shots pierce enemies but not rocks, fire, or poop. Shots can't be angled, and will not provide knockback. Shots come from Isaac's left eye only (so if you aim up, they are to the left, down they are to the right, left they are below your aim, and right they are above it).

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.

When combined with Ouija Board or Spirit of the Night, the beam becomes transculent and passes through objects.

When combined with Polyphemus or Mutant Spider, it creates a large laser that does Maximum damage, but can only be fired periodically (about 1.5 seconds in between shots).

When combined with Sacred Heart, the laser will turn purple and do more damage. The white eye effect on Isaac is cancelled.


Isaac gets a cyborg eye.





Removes Isaac's body, allowing flight over obstacles, spikes and pits.

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.

This item appears only in Secret Rooms.

Unlocked by completing the game twice.

File:Transcendance Isaac.jpg

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.

No visual effect. (A,1,7)

The Virus

File:The Virus.png

Gives Isaac 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.

File:The Virus.jpg

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.

Unlocked by completing the game 7 times.

File:The Wafer Isaac.jpg

Isaac starts glowing around his head.

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Whore of Babylon


If you have half a heart, a message reading "What a horrible night to have a curse..." appears on the screen and the player becomes the Whore of Babylon. This increases their damage by 3 and speed by 2 and they will stay in that form until leaving a room with more than half a heart.

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: Video

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 or 15 coins as well.

When activated while the player has Fate, the Holy Grail, or the Bible activated, the wings turn black.

File:Whore of Babylon Isaac.jpg

Isaac becomes a spawn of Satan.


Wiggle Worm


Gives Isaac 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. Does not synergise with Technology 2's beam but does with normal tears.

May increase homing effect for homing tears.

Found in the Shop or Item Room.

File:Wiggle Worm.jpg

Isaac's eyes shrink and become jittery.


Wire Coat Hanger

File:Wire Coat Hanger.png

Increases Tears by 2.

Found in the Boss Room.

File:Wire Coat Hanger Isaac.jpg

Isaac gets a coat hanger through his head.

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Wooden Spoon

File:Wooden Spoon hq.png

Increases speed by 2.

Found in the Boss Room.

File:Spoon Isaac.jpg

Isaac has beat marks from a spoon.


X-Ray Vision


Reveals and opens Secret room entrances.

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.

File:X-Ray Specs Isaac.jpg

Isaac wears X-Ray glasses.

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Wrath of the Lamb Collectible Items

The following collectible items can only be acquired if you have the Wrath of the Lamb DLC.

Name and Icon Effect Info Collection Grid (Pg,X,-Y)

3 Dollar Bill


Effect given changes every room. It can give you the effect of: Mom's Contacts, My Reflection, Number One, Ouija Board, Spoon Bender, The Inner Eye, Tough Love and Magneto (via bug).

Since it can grant the Magneto effect, it can be used to aquire items (bombs, keys etc.) you otherwise couldn't, by repeatedly leaving and re-entering a room.

Also a very bad synergy caused by My Reflection effect from 3 Dollar Bill with Ipecac. It causes Ipecac shots to follow the player until they hit an obstacle or wall.

The name most likely comes from the slang "Queer as a 3 dollar bill".


Isaac appears to be happy. Stars appear around his eyes when he fires tears.



File:Wotl abel.png

Mirrors Isaac's movements. Shoots in opposite direction to the player. (In essence, a friendly Dople. )

Bug: When combined with Holy Water, the Holy Water will assume Abel's movements and Abel will follow you as a normal familiar.

Unlocked by completing the Cathedral as Cain

Isaac Abel

Follows The Player.




When killed, respawns in the previous room as ???, regardless of the fact he is unlocked or not. After respawn, all future HP upgrades will be spirit hearts only. Only works once.

If you are playing as ???, and you are wearing this when you die, you're simply revived in the previous room with 3 soul hearts (similar to 1 up).

(If you defeat any end game bosses, you will have the achievements from ??? instead of your first character, although if you die it shows the name of your original character).

The Ankh triggers before 1up.

New. With the Dead Cat item, if you die as ??? you will respawn as your previous character with 1 Heart Container.

Note: The Ankh effect will occur before the effect of the Dead Cat, so you will first respawn as ??? before using up any of the 9 lives obtained via the Dead Cat.

Note: If the "Real Last Boss" is killed by ??? made using the Ankh (from Isaac), the game gives you Eve's Bird Foot and Steam gives you "Samson's Lock achievement". (Surely a two-bug)

File:Isaac Ankh.png

Isaac wears an ankh around his neck and gets a slight eye shadow.


The Black Bean

File:Black Bean.png

When taking damage, Isaac farts, causing poison damage to all enemies in range. Same as Bad Gas pill.


Fatter - as with Bucket of Lard, but with a slightly darker hue.

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Bloody Lust

File:Bloody Lust.png

Increases damage each time Isaac kills an enemy for the current room. Isaac and his tears turn red with more power gained.

Samson starts with this item. Some enemies, such as Globin , and some bosses, such as Larry Jr, will increase damage during the battle as their healths are "tiered".

When used with Chocolate Milk, charged shots are smaller and weaker.

"MEAT!" and "Toothpicks" do not increase tears when the Red Bandana has been collected beforehand.

Can be used in conjunction with The Necronomicon to build rage by destroying enemy shots.

File:Isaac Bloody Lust.png

Isaac wears a red bandana.

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Bob's Curse


Gives 5 bombs and grants all bombs poison effect. This includes bombs fired from Dr. Fetus, Missile from Epic Fetus, Best Friend decoy, enemy bombs, troll bombs and gunpowder kegs.

File:Bob's Curse.pngBobBomb

Isaac's head appears diseased. Bombs turn into Bob's Rotten Head, with no fuse.

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Spawns 1 of each item: 1 coin, 1 key, 1 bomb, 1 heart, 1 card, 1 pill, 1 trinket.

Decreases speed by 1

Variants of each item (such as nickels and troll bombs) may also spawn instead

A drop from common bosses.

Bug: Regular or half hearts never drop, only Soul and Eternal Hearts.

File:Isaac Cardboard Box.png

Isaac wears a box around his torso and when turned sideways the box says "Isaac".


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. If he gets a dime or nickel, it will be counted as getting multiple coins in a row, so he will probably drop multiple pickups. Doesn't drop items.

Reverts Little Steve, Robo-Baby, Rainbow Baby, and Little Gish to Brother Bobby. Getting Brother Bobby will change your familiar back to its normal form.

Pushes your bombs.

File:Isaac Bum Friend.png

Familiar: Follows the player.




Tears will travel faster. Bonus does not stack with Speed Ball.

Found in the boss room.

When used in conjunction with Brimstone, the amount of time the laser is fired for is lessened (meaning less damage potential), without any real plus.

File:Isaac Cat-o-nine-tails.png

Isaac recieves large cuts all over his face.


Celtic Cross


Small (30%) chance to cast the Book of Shadows shield on Isaac upon taking damage.

Works well in conjunction with the IV Bag, which will provide coins at no health cost while the shield is up.

Unlocked by completing the Cathedral as Magdalene


A celtic cross circle appears behind Isaac's head.


Chemical Peel


Tears fired from left eye (side of face that is peeled) do increased damage. This stacks with the damage increase from The Peeper.

Does not work in conjunction with Mutant Spider.

When used with Cain, tears will randomly do increased damage.


Half of Isaac's face is burned off.

Movie strip


Daddy Longlegs


Daddy Long Legs' shadow follows player and stamps on enemies. The leg does not hurt the player.

In some situations, Daddy Long Legs will be replaced with Triachnid's leg.

During the fight with Isaac will only stomp the boss once and won't come down again until Isaac has been defeated.


Shadow follows the player.


Dead Dove


Gives Isaac spectral tears and flight.

Found in Item Room, God Room and Library.

File:Dead dove look.png

Isaac's body becomes a phantasmic aura, and his face turns soulless.


Epic Fetus


Tears become guided missiles (See The Doctor's Remote item). Locks firing rate (including that of multi-shot effects like Mom's Eye) to the time it takes for the missile to strike and detonate. Overrides Dr. Fetus and Mom's Knife. Use the Mouse for convenience. Usually found in the Secret Room.

Clashes with Brimstone, causing very slow Brimstone charge and a missile to follow the shot.

Combined with Technology 1 causes to shoot an invisible laser at the rate of Epic Fetus's rockets.

Has priority over Fetus in a Jar.

Unlocked by completing the 'The Doctors Revenge!' Challenge.

Technology 2 causes Epic Fetus to stop working.

Bugs: If used when Mom's Bra is in effect the aim will freeze after a really short time, causing the player to be unable to move the crosshair.

Bob's Curse makes green explosion when the missile lands but the poison effect doesn't work like the common cold and Dr Fetus.

File:Isaac Epic Fetus.png

Isaac looks like he would with Dr. Fetus, just with an angry eyebrow over the monocle.




Isaac gains flight and an Eternal Heart.

The sprite is actually from Edmund's 'DeadBaby VG Dressup' game on New Grounds. It appears on the Dead Baby and in the background of the loading / menu screen.

Rarely found in golden chests.

Isaac Fate

Isaac grows angelic wings.


Ghost Baby

File:Ghost baby bigger.png

Familiar that shoots spectral tears.

If you have Spider's Bite, Ghost Baby's tears can also inflict the slowing effect.

Isaac Ghost Baby

Follows the player.


Guppy's Hair Ball


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.

Unlocked by transforming your Character into Guppy. Achieved by collecting 3 Guppy items in one playthrough (any combination of Guppy's Tail, Dead Cat, Guppy's Head, and Guppy's Paw. You don't need to keep the Paw or Head, just activate it at least once).

Found in the item room.

File:Guppy's hairball.jpg

Follows the player.


Guppy's Tail


Increases chance of gold chests and normal chests.

Also decreases the chance of other normal pickups (Not only keys), a reference to the "Cursed?" Caption.

Found in Challenge Rooms, the Devil Room and Red Chests.

When combined with 3 other Guppy items, Isaac will turn into Guppy. He will also gain the Mulligan effect and the ability to fly.

File:Isaac Guppy's Tail.png

Isaac wears Guppy's tail around his waist.




When hit, refills some item charge. When used in tandem with healing items such as the Book of Revelations or Yum's Heart, it is possible to have nearly infinite life.

Does not refill charge when shielded by the Book of Shadows.


Isaac wears a nun's habit.


Harlequin Baby


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

Found in the Item Room.

Trivia: This item is based on a real medical condition named Harlequin Ichthyosis that deforms infants, causing them to have scaly skin, a strangely shaped body, and sunken, red eyes and lips.


Familiar: Follows the player.


Holy Grail


Adds 1 empty heart container and gives flying ability.

Isaac Holy Grail

Isaac grows angelic wings and recieves a saint's halo.


Holy Water


When Isaac receives damage the vial breaks and a blue spot that damages foes forms, similar to that of Lemon Mishap.

The vial is reformed upon entering a different room.

Note: Reverts Rainbow Baby into Brother Bobby, Robo-Baby into Brother Bobby, Harlequin Baby into Brother Bobby, Sister Maggie into Robo-Baby, Little Gish into Brother Bobby, and Li'l Steve into Brother Bobby unless currently broken/spilled (Bug)

Holy water

Familiar: Follows the player.




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

File:Isaac Infestation.png

Isaac becomes infected, his body gets fatter and green.




Green projectiles fired from the mouth causing poison/explosive damage. Shots are fired in an arc, so they will fly over enemies unless extremely close (close enough to take damage from the explosion).

will make dr.fetus bombs green and will make the reloading time way longer

Great interaction with Spoon Bender, Sacred Heart or Telepathy for dummies. Causes shots to home in on enemies and almost never miss

Isaac Ipecac

Isaac gets very sick and he spits his projectiles.

Movie strip


Jesus Juice

File:Jesus juice-clear-.png

Despite text due to bug increases damage instead (adds 1/2 of your current damage stat).

File:Isaac Jesus Juice.png

Isaac has purple juice stains surrounding the mouth.


Magic 8 Ball


Increases Shot Speed.

Bug: Althought the text says "tears up", it does not increase your tears.

Also spawns one tarot card when collected.

File:Isaac Magic Eight Ball.png

Isaac wears the headdress of a fortune teller.




+1 Max HP and tears.

Unlisted effect: damage up.

Bug: Althought the text says "tears up", it does not increase your tears.

(MEAT! is a reference to Bonk's Adventure from TurboGraphix16 / PC Engine)

File:Isaac Meat.png

Isaac gets angry with a bulging vein.



File:The Mitre.png

Greatly increases the chance of replacing spawned hearts with soul hearts.

Stacks with the trinket Mom's Pearl.

File:Isaac The Mitre.png

Isaac gains a holy aura.


Mom's Purse

File:Mom's Purse.png

Hold 1 additional trinket.

Commonly found in shops.

File:Isaac Moms Purse.png

Isaac wears his mom's purse at his side.


Mom's Coin Purse


Spawns several pills around Isaac.

Commonly found in Shops and after fighting bosses.

File:Isaac Moms Coin Purse.png

Isaac gains a small coin pouch hanging from his neck.


The Mulligan


Chance to spawn Blue Flies on successful hits, which charge current target.

If combined with Mutant Spider, will spawn many more flies.

If combined with Technology 2, will spawn many flies because Technology 2 has a very high fire rate.

Named after the enemy of the same name.

Bug: When combined with Brimstone, you can't fire.

Bug?: Blue fly attacks can spawn more blue flies, creating many when on max luck.

File:Isaac The Mulligan.png

Isaac gets fly bites all over his face.

The Mulligan Tears


Mutant Spider

File:Mutant spider.png

Shoot four tears at once, greatly reduces tear firing rate.

Functions as The Inner Eye when paired with Loki's Horns and Moms Eye, causing Loki's horns to always fire. Can be combined with Technology 2.

Overrides The Inner Eye.

File:Isaac Mutant Spider.png

Isaac gets two more eyes, as well as two small fangs

Mutant Spider Tears


Pageant Boy

File:Pageantboy icon.png

Spawns several coins around Isaac. (May include nickels and dimes)

Chance of spawning coins on being damaged.

A drop from common bosses.

Increases the chance of getting coins from slot machines.

File:Isaac Pageant Boy.png

Isaac wears a pink crown.


The Peeper

File:Peeper icon.png

Gives Isaac a familiar eye that floats around the room, damaging enemies on contact.

Tears fired from left eye socket do increased damage. This stacks with the damage increase from Chemical Peel.

Floating eye WILL push bombs.

(The Peeper is a refrence to Peep, a boss in The Caves.)

Bug: Tears fired from left eye socket do not do increased damage.

File:Peeper visual.png

Isaac loses an eye. Tears from left eye become blood.




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

Note: if combined with Cupid's Arrow, shots will turn red and tear size won't decrease if tear does more damage than enemy has life. Tear stays maximum size and pierces enemies.

Stacks with Brimstone and Dr. Fetus, but makes charge requires longer amounts of time. However, the damage also stacks, resulting in an attack that will one hit most bosses, making even the Chest obscenely easy.

Stacks with Chocolate Milk.

Stacks with Sacred Heart.

Stacks with Inner Eye and Mutant Spider, allowing you to keep your triple or quad shot.

If combined with Jesus Juice, damage is maximized and shots turn into blood.

Maximizes the damage of Technology 2 if taken after Tech 2.

Stacks with Tough Love. The black eye and swollen mouth will still appear, overlaid on the cyclops eye.

Stacks with mom's eye, making you shoot in both directions on every shot.

The name of this item is a reference to the name of the cyclops from The Odyssey.


Isaac becomes a cyclops.





Adds 99 Bombs. Can rarely be found in the Secret Room.

File:Pyro action.png

Isaac grows four fuses on his head.


Rainbow Baby


Tear Effect changes every shot.

Effects include V tears, slowing tears, bloody tears, etc.

Unlocked by completing Cathedral as ???

Rainbow baby

Familiar: Follows the player.

Movie strip


Sacred Heart

File:Sacred heart.png

Shots are larger, travel slower and home in on enemies. Damage is multiplied. Decreases Tears by 1.

Gives 1 Soul Heart and restores full Health on Pick up. Found in Holy Room, Curse room, and from the devil beggar.

When aquired with the Fetus in a Jar item your fetus bombs will follow targets (home in on them), and regular bombs will also home on enemies.

Sacred heart Isaac

Isaac's eyes glow white, and glowing tears stream down his face.


Sacrificial Dagger


Dagger orbits Isaac, very high damage.

Unlocked by completing the Cathedral as Eve.

File:Isaac Sacrificial Dagger.png

Orbit: Circles the player.




Whenever Isaac is downed to 1/2 of his last Heart, Aura around his head temporarily vanishes and he is are granted 1 Soul Heart.

Works differently on ???. When ??? takes damage and he has no Soul Hearts left, he immediately gains 1 Soul Heart, Aura temporarily vanishes. Recharges upon leaving a room.

This can be used to infinitely collect coins using blood donation machines/iv bags when on half a heart by exiting and re-entering the room. With the habit, it can also be used to infinitely recharge spacebar items.


Isaac has a yellow aura around his head.

Bug: If you own the Cursed Skull you'll be invicible against foes except Mom

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SMB Super Fan!

File:SMB Super Fan.png

Increases all stats except Speed by 1. Reduces Speed by 1.

Unlocked by completing Meat 4 Evar! challenge.

File:SMB Isaac.png

Isaac takes on the appearance of Super Meat Boy, with red skin, chipped tooth, black eye and Isaac leaves a trail of blood where he walks.


Speed Ball

Speed Ball

Increases movement speed and causes tears to travel faster. Tear speed bonus does not stack with Cat-o-Nine-Tails.



Isaac's eyes become dilated, and he has a small grin on his face. He also has a syringe jammed into the back of his head.


Spirit of the Night

File:Spirit of the Night.png

Grants Isaac flight and spectral tears.

This is most likely a reference to the Magic: The Gathering card of the same name.

Can be found in the Devil Room.

File:Spirit of the Night Isaac.png

Isaac is black with ghost tail, white eyes and a strange mouth.




+1 tears and spawns 2 soul hearts.  : File:Isaac Squeezy.png

Isaac's eyes pop out of his head.


Stem Cells

File:Stem Cells.png

+1 heart container. It also heals a half heart.

File:Isaac Stem Cells.png

A fetus grows on the side of Isaac's face.




Boosts Isaac's damage by 1 and grants you one container heart.

Found in the Item Room.

File:Stigmata Isaac.jpg

Isaac has a stream of bloody tears on his face.


Technology 2

File:Technology 2.png

Fires a continuous laser as you shoot tears. Pierces enemies. When used with Cain, will prevent tears from firing from other eye.

Details here.

Technology 2 Isaac

Isaac gains a laser-enhanced eye

Movie strip




Increases Tears. Range goes down by 1 and causes tears to travel faster. Turns tears to blood (visual effect only).


Both eyes are held up with toothpicks, tears become red.


Tough Love


Isaac randomly shoots teeth instead of tears, dealing more than triple damage, the extra damage can go over the damage limit allowing you to deal triple the max damage.

The chance of shooting teeth is related to luck stats, which can be altered with Lucky Toe, Luck Up and Luck Down Pills. With maxed luck stats (9) Isaac always shoots teeth.

When stacked with Mutant Spider or the Inner Eye, more than one shot can be a tooth.

When stacked with Parasite, split shots can also become a tooth.

Contrary to bullet effect the teeth DO NOT have splash effect.

Found in the Item Room.

File:Toughlove visual.png

Isaac is beaten up.


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Tarot Cards

Pill Effects

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