A single six-sided die, red in color with black spots indicating the number associated with each side.
This item is initially locked and unavailable to the player. It can be unlocked by defeating Mom's Heart/It Lives! with ???. Once it is unlocked, Isaac will always start the game with this item equipped.
Upon activation, any Items in the current room will be 're-rolled' and turned into another item that corresponds with that room's Item Pool. This effect is limited to collectible items, i.e. those which appear on a pedestal, and has no effect on Pick Ups.
For example, if Tammy's Head spawns from a Golden Chest, re-rolling it will result in an item from the Golden Chest Pool. However, if Tammy's Head spawns from a Golden Chest in a Boss Room, rerolling it will result in an item from the Boss Room Pool instead of one from the Golden Chest Pool.
- As with most Activated Items, Items such as Habit, 9 Volt and The Battery decrease the charge time, increasing the effectiveness of this item. As it recharges in three rooms and very rarely can be used to best effect during combat, 9 Volt would be a strictly better choice than The Battery in most scenarios, unusually, although The Habit trumps all as always.
- The Dice can also be used to re-roll shop merchandise (only Collectibles) and offers from the Devil Room or the Angel Room.
- Exhausting the Library item pool with The Dice will cause it to draw from the Treasure Room item pool, essentially making Libraries the equivalent of two Treasure Rooms.
- Using The Dice in a room with no items will do nothing, and the charge will be wasted.
- The Dice will not re-roll alternative boss drops: Steven and Little Steve dropped by Steven (Excluding Steven (item), however, as it is in Steven's drop pool), Little Gish dropped by Gish, Little C.H.A.D. dropped by C.H.A.D., A Pony dropped by the Headless Horseman, Cube Of Meat dropped by The Harbingers, and White Pony dropped by Conquest. However, picking up A Pony or White Pony will allow it to be re-rolled once The Dice is re-obtained.
- The Dice can re-roll Small Rock, obtained from Tinted Rocks. The re-roll is drawn from the Treasure Room item pool.
- Dying with the Ankh, respawning as ???, and killing Mom's Heart/It Lives! will unlock the Dice.
- The graphic shows a die from the one angle that displays its three worst sides together (1, 2 and 3). This could be symbolic of Isaac's luck.
- It is possible to obtain items obtained through achievements without having to unlock the achievement.