A bloody knife, with a red handle.
The knife orbits Isaac, doing very high damage to any monster it touches.
Blocks incoming shots.
- Book Of Shadows - Allows you to do high damage to enemies without taking damage.
- Works well with Guardian Angel
- This item looks similar to Mom's Knife, flipped upside down, with blood on the blade and a red handle, although there are small differences in the design, indicating that the developers just flipped the image of Mom's Knife.
- The in-game secret message refers to it as "Sacrificial Knife"