Upon activation, Isaac will raise the pickaxe over his head, and hold it there until he touches a rock, poop, or fire breaking/extinguisting it instantly. The item can only be used to break one rock per room and it slows the player down by 75% during use.
- This item is highly situational, and is considerably less useful when flying items, or The Nail have been obtained.
- It is useful for getting to an item and saving a bomb.
- It can be used to obtain items from Tinted Rocks. Rarely, if ever, will there be more than one in a room.
- It can be used to create a crushed rock bridge, although the direction the targeted rock "falls" appear to be random.
- The item is a reference to the game Minecraft and its creator Markus 'Notch' Persson.
- There is also an item in The Elder Scrolls V: Skyrim called the Notched Pickaxe.
- If you pick up another activated item while the Notched Axe is activated you will still get one free use of the axe even if you are not holding it. In this phase you can't shoot, so rooms with enemies will be your death if you have no items as the Cube Of Meat to damage them by touch. Only hitting a rock or picking up an item will help you end this bug.