By his low starting stats, a run played as Samson could be difficult to finish (low range and tears, low-average speed and attack power) and his starting item Bloody Lust, is both not a very good item (being previously nerfed, making it less effective) and a special item (no longer the case, as of Eternal Edition), which decreases the chances to find other special items throughout the rest of the game. Bloody Lust can help at the beginning of the game, giving you some power to take down foes. However, his starting health is very low (one Heart Container and one Soul Heart), making him a very fragile character. He is described by Edmund McMillen as the "Berserker"; he needs to survive to deal a very high amount of damage.
Samson is a tough character to use and has to rely a lot on his Bloody Lust item, which is not always helpful. Rooms containing fewer enemies create a bigger challenge for him, as he is not able to use the power boost from Bloody Lust to his advantage. This becomes an even bigger challenge when he has to face bosses that don't spawn weaker enemies (Monstro, The Carrion Queen, Peep, etc.) and don't have sections that can be destroyed (like Larry Jr. and The Hollow). His shot speed is very quick (causing weird knockback on enemies, making you get hit often), and he has a fairly low rate of fire.
- Try to get extra Heart Containers or Soul Hearts (Dessert, Dinner, etc for regular hearts or tinted rocks and Shops for Soul Hearts) as often as possible. You must boost his defense to grant him a chance to survive.
- When entering a room full of enemies, try to pick on the weakest foe first. Each successive kill will make you clear the room faster, thus helping you conserve precious health.
- In the case of fighting a boss who summons monsters (Widow, Chub, Gurdy, some Horsemen, etc), you should kill some of them before defeating the boss; the Bloody Lust gives you attack power each time a foe is killed, then you will be more powerful against the boss.
- As he starts with no bombs/keys or even money, think before you use one of them; they are precious, especially if you can find a Secret Room. It can contain very useful items or money to buy boosts at the shop.
- Like Judas, avoid doing deals with the devil too early in the game. Samson's base health is too low to risk such a lack of life.
- Items like The Candle help you deal damage until Bloody Lust gives you more attack power (tears destroyed by the candle's flame also count towards added damage).
- Visiting Curse Rooms is not recommended early on, unless you're sure you can replenish your health.
- Due to starting with Bloody Lust, he can do fairly well in the Challenge Rooms. Boss Challenge Rooms are also a possibility.
- Try to find Trinkets that give you more bombs/keys, like the Flat Penny and the Burnt Penny. Isaac's Fork is good too if you are getting hit often.
- As a Globin can trigger the Bloody Lusts effect by just being knocked down without being definitively killed, they may be farmed for damage in a room. Be careful if using this tactic though, as they deal high damage and can quickly kill you if they get close.
- Bloody Lust (of course)
- Health increasing items (Dinner, Stem Cells, Breakfast, etc.)
- Prayer Card
- Book of Shadows
- The Wafer
- The Parasite
- Spoon Bender (Although less effective for Samson due to his high shot speed)
- The Halo
- The Nail
- Book of Revelations
- Halo of Flies
- The Relic
- The Candle
- Magic Mushroom
- Tear increasing items (such as Mom's Eye, The Sad Onion, Wire Coat Hanger, etc.)
- Mutant Spider
- XIII-Death tarot card
- The Necronomicon
- Spider Butt
- Charm Of The Vampire
- Little C.H.A.D. (Causes Relic to drop less often)
- Lucky Foot
- The Common Cold
- Flight granting items (Lord of the Pit, Holy Grail, Transcendance, etc.)
- Range increasing items (Mom's Lipstick, Mom's Heels, Mini Mushroom, etc.)
- A Lump of Coal
- Mom's Contacts
- Spectral tear granting items (Ouija Board, Dead Dove, Spirit of the Night, etc.)
- Guppy's Paw
- Guppy's Head (Blue flies will clear a few enemies at the start of each room, causing Bloody Lust to activate immediately)
- Kamikaze! (Can be good if walking into walls, which makes you not take damage) Fixed, as of Eternal Edition.
- Razor Blade
- Blood Rights
- IV Bag (Alright if there are spare hearts just laying around)
- Dead Bird (Is not so much "bad" as you shouldn't activate it too often ideally, because you don't want to take damage)
- Chocolate Milk (Charged shots are weaker with Bloody Lust)
- Number One (Samson's range is too poor to take advantage of the maxed tears without being able to survive comfortably, unless you have gotten to a decent range stat through pills or items)
- Mom's Knife (Range is too low to effectively make use of it)
In Rebirth Edit
Samson is almost completely remade in Rebirth edition: Bloody Lust (Rebirth) is totally different from the original Bloody Lust, which results in Samsom have to take damage for multiple times in order to maximize the effect instead of killing enemies, and the effect lasts for the whole floor, not only the present room. Samson`s life stat is also remade so as to match this revision, Samson now has 3 Heart Containers instead of one Heart Container and one Soul Heart.This might be a reference to the "Berserker" nature of Samson described by Edmund, since in traditional RPG berserkers frequently boost in power when taking damage.
- Bloody Lust (Rebirth) is fully activated by taking damage for 6 times and also increase your base damage for 6 times.Therefore, Samson`s DPS in Rebirth can be much higher than other characters simply by stacking Bloody Lust.Upon playing Samson, you might want to gain the complete effect of Bloody Lust as soon as you enter a new floor since his base stats are still low,but you must keep an eye on the increasing of damage taken in floors after The Womb/Utero, because of which you have to risk taking too much damage.Of course,The Wafer prevents you from this, therefore it is quite useful to him.
- Although the mechanic of Bloody Lust (Rebirth) differs from the origin, Samson may still need to gain as much Heart Containers as possible——In some occasions they are even more necessary than in the original game,since Samson has to take tons of damage in order to increase his DPS. He also require enough healing and/or soul(black) heart apply.
- All Items and Trinkets that offer you extra Heart Container or healing might be extremely beneficial to Samson, due to these reasons above.
- When you are trying to stack up Bloody Lust, A clever idea is to find enemies that are predictable and deal only 1/2 heart damage to you; An even better idea is to use some self-damage items that enable you to gain both Bloody Lust effect and the effect of these items at the same time, costing the same half of heart.For example,Blood Rights enables you to deal massive damage to enemies while increasing damage of your own tears, preparing for upcoming battles.