Capricorn
All stats up
All stats up.
Flush!
...
Changes all enemies in the room into poop. Does not work on all enemies (Knights and bosses are immune). Instantly kills Dingle, Dangle, and Brownie.
Book of Revelations
Reusable soul protection
Adds 1 soul heart, increases the chance for a Devil or Angel Room to appear, and increases the chance for the next boss to be a Horseman (except on XL floors and floors with fixed bosses such as Mom).
Purity
Aura stat boost
This item will boost one of Isaac's stats depending on the color of the aura around him. The aura will disappear upon taking damage and will reappear with a random color upon entering a new room. A red aura boosts damage, a blue aura boosts rate of fire, a yellow aura boosts speed, and an orange aura boosts range.
Safety Pin
Evil + range + shot speed up
Increases range and shot speed, while adding 1 Black Heart.
Aquarius
Trail of tears
A trail of blue creep is left behind Isaac, which damages enemies.
Eye of Greed
Gold tears!
Adds a chance to fire tears that temporarily stun enemies and turn them into gold. Any enemy killed while in this state will drop coins.
Broken Watch
I think it's broken
Chance upon entering a room to slow down or speed up every enemy and their attacks. The chance to slow enemies is quite higher than the chance to speed them up.
7 Seals
Lil harbingers!
Grants a random Harbinger familiar that changes every 10 seconds.
Dry Baby
Immortal Friend
Spawns a familiar that follows Isaac around and blocks enemy projectiles. Upon blocking a shot, it has a chance of triggering The Necronomicon effect.
Spider Bite
Slow effect
Adds a chance to shoot slowing tears, reducing speed of enemy movement and any projectile fired by them.
Lost Fly
Lost protector
A familiar fly that moves in a straight line and attaches itself to the first obstacle or wall it comes into contact with in each room. If any enemies walk into its path, it will deal 7 contact damage per tick. If the obstacle it is attached to is destroyed then it will continue rolling in the direction it was previously travelling until it meets another wall or obstacle.
The Common Cold
Poison Damage
Adds a chance to shoot poison tears, dealing damage over time when inflicted.
Trisagion
Smite thy enemy
Tears are replaced with piercing white blasts of light.
Thunder Thighs
HP up + speed down + you feel stompy
Destroys rocks upon contact with Isaac. Adds one heart container and lowers Speed.
Tiny Planet
Orbiting tears + range up
Range up and makes shot tears revolve around Isaac until they drop.
Gnawed Leaf
Unbreakable
After standing still and not shooting for a short time, Isaac turns invincible until he moves or shoots.
Immaculate Conception
Feed them love
Upon picking up a certain amount of health, spawn a permanent angelic familiar.
Shard of Glass
Blood and guts!
Upon taking damage, Isaac has a chance to drop a full red heart, gain 5 range, and leave a trail of damaging red creep for the current room.
Holy Water
Splash!
When Isaac receives damage, the bottle breaks and a puddle of blue creep forms, which damages non-flying enemies, similar to Lemon Mishap. The bottle is reformed upon entering a different room.
Ball of Bandages
Gotta lick 'em all!
Orbiting familiar that deals damage to enemies. If collected while already having one, makes the familiar evolve. Only drops from Horsemen. Similar to Cube of Meat.
8 Inch Nails
Stick it to 'em!
+1.5 Damage Up. Replaces Isaac's tears with nails, which have increased knockback.
Cube of Meat
Gotta meat 'em all!
Orbiting familiar that blocks enemy shots and deals damage to enemies. If collected while already having one, makes the familiar evolve. Only drops from Horsemen. Similar to Ball of Bandages.
Mom's Bottle of Pills
Reusable pill generator
Gives Isaac a random pill, and will cause him to drop any held Q-slot item (If any). The player will only receive six different pill types in one playthrough.
A Lump of Coal
My Xmas Present
The more distance tears travel, the more damage they will do.
Sharp Plug
Charge with blood
Using an activated item while it's not charged will charge it and Sharp Plug does 2 full heart damage to Isaac.
Hushy
Lil hush!
Spawns a Hush familiar that bounces around the room and deals contact damage. While firing tears, it stops moving.
Bogo Bombs
1+1 boom!
All standard bomb pickups become 1+1 bomb pickups.
Fate
Flight eternal
Grants flight and one eternal heart.
Dinner
HP Up
Adds 1 heart container.
The Jar
Save your life
When at full health, up to 4 extra hearts can be stored in the jar.
Mom's Knife
Stab stab stab
Isaac's tears are replaced by a knife that pierces enemies, can travel through obstacles, and can hurt enemies while Isaac is holding it. Holding down the fire button before firing increases its range and power.
Doctor's Remote
Reusable Air Strike
Sets a big red target on the ground (similar to the Epic Fetus item) which can be controlled with tear controls. After 6 seconds or by pressing space again, a huge explosive missile hits it, which damages all enemies caught in its blast radius.
Sissy Longlegs
She loves you
Wanders about the room, occasionally spawning blue spiders.
D12
Rerolls rocks
Re-rolls all rocks in the current room into other random objects, such as bomb rocks, metal blocks, TNT, or poops.
Distant Admiration
Attack fly
A red attack fly circles further out than the Halo of Flies / Pretty Flies, but closer than Forever Alone. Deals more damage than Forever Alone.
Broken Shovel
It feels cursed
While held, causes multiple Mom's Foots to come down and stomp on Isaac. One of two parts necessary to create Mom's Shovel.
Angelic Prism
Eclipsed by the moon
Grants a prism orbital with a large orbital radius. Tears that pass through the prism split into four multi-colored tears.
Eden's Blessing
Your future shines brighter
+0.7 tears up. Grants a random item at the start of the next run.
Spirit of the Night
Scary
Grants spectral tears and flight.
Converter
Convert your soul
When used, converts two soul hearts into a heart container.
Empty Vessel
I reward an empty vessel
While Isaac has no red hearts, this item grants flight and a random chance to activate an invincibility shield for a few seconds. If Isaac gains any red hearts, these benefits will disappear.
We Need to Go Deeper!
Reusable level skip
Creates a trapdoor to go to the next floor. If used in The Womb, it will create a trapdoor to Sheol, even if the player hasn't unlocked it.
Mom's Coin Purse
What's all this...?
Spawns 4 random pills around Isaac.
3 Dollar Bill
Rainbow tears
Gives Isaac a random tear effect every room. The effect given changes upon entering a room. The effect changes every 3 seconds.
Dark Matter
Fear shot
Increases Damage by 1 and adds a chance to shoot fear tears.
My Shadow
Me! And my shaaaadow!
Each time Isaac takes damage, inflicts fear on all enemies in the room and spawns a black friendly Charger that will attack enemies. The Charger will be killed if it is damaged too much.
Big Fan
Fat protector
Spawns a large orbital familiar that blocks enemy projectiles and deals slight contact damage to enemies.
Little Steven
Psychic friend
Spawns a familiar that follows Isaac around and fires homing tears.
Guppy's Hair Ball
Swing it
Loosely follows behind Isaac. Can be swung like a flail by rapidly spinning Isaac in a circle. Grows bigger by killing enemies.
Transcendence
We all float down here...
Grants flight.
X-Ray Vision
I've seen everything
Reveals and opens all Secret Room and Super Secret Room entrances.
Blood Rights
Mass enemy damage at a cost
Damages all enemies in the room, but deals a heart of damage to Isaac with each use.
Dead Dove
Flight + spectral tears
Grants spectral tears and flight.
Habit
Item Martyr
When Isaac is hit, 1 point of an item's charge is filled.
Spoon Bender
Homing shots
Grants Isaac homing tears.
Humbling Bundle
1+1 free 4evar!
Gives one extra pickup (1+1 Free version) of Red Hearts, pennies, bombs, and keys. Does not work with blue, black, and half red hearts, nickels, and dimes.
Broken Modem
Lag!
Enemies, enemy shots, tears, and pickups will briefly freeze in place at random intervals.
Potato Peeler
A pound of flesh
Removes a heart container, increases damage and range, and grants a Cube of Meat.
Mini Mush
Speed + range up
Increases Speed and Shot Height and decreases Isaac's size, but lowers Range.
Sacrificial Dagger
My fate protects me
Dagger orbits Isaac, dealing very high damage.
The Hourglass
Temporary enemy slowdown
Upon activation, enemies and their projectiles are slowed down for a short duration.
Breakfast
HP up
Grants Isaac one full red heart container.
Starter Deck
Extra card room
Isaac can hold 2 cards at once and all pills are replaced by cards.
Smart Fly
Revenge fly
After Isaac takes damage, this fly will deal continuous touch damage to whatever enemy caused the damage until it is dead. The fly will then systematically attack 1 enemy at a time until the room is cleared.
Infestation
They grow inside
1-3 blue flies randomly spawn every time Isaac gets hit.
The Small Rock
DMG up
Increases damage by 1, increases tears by 0.2, and decreases speed by 0.1.
Night Light
Scared of the dark?
A cone of light shines in the direction Isaac is moving that slows enemies and enemy shots.
Gimpy
Sweet Suffering
Has a chance of spawning a soul heart or black heart when taking damage. Enemies have a chance to drop a Half Red Heart after being killed.
Tough Love
Tooth shot
Adds a chance to shoot a tooth instead of a tear, which deals greater damage than regular tears.
Hot Bombs
Burning blast +5 bombs
Grants 5 bombs. Isaac's bombs leave behind fire that damages enemies upon contact.
Jar of Flies
Gotta catch 'em all?
Every time Isaac kills an enemy, a fly will be added to the jar, up to a maximum of 20. Using the Jar of Flies will release all the flies that are currently in the jar as friendly blue flies that will damage enemies.
Ball of Tar
Sticky feet...
Adds a chance to shoot slowing tears and the character leaves a trail of slowing creep behind as he moves, impeding enemies' speed.
Host Hat
Nice hat!
A host familiar that sits on Isaac's head and has a random chance to block enemy shots and retaliate with 3 tears. Grants immunity to explosions.
The Belt
Speed up
Increases speed by 0.3.
Glyph of Balance
A gift from above
Grants 2 soul hearts and modifies drops from Champion Monsters based on certain conditions.
Caffeine Pill
Speed up + size down
Increases speed and reduces character size. Also gives a random pill.
Brother Bobby
Friends 'till the end
Follows Isaac around shooting normal tears.
D10
Rerolls enemies
Rerolls the enemies in a room. Only rerolls enemies that are still alive (does not spawn new enemies).
Compound Fracture
Bone tears!
Increases range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle.
Wooden Nickel
Flip a coin
When used, has a 50% chance to drop one random type of coin (penny, nickel, or dime).
E Coli
Turdy touch
Gives "Turdy Touch" Effect. Enemies that touch Isaac are changed into poop.
Sagittarius
Penetrative shot + speed up
Increases speed by +0.2 and grants piercing tears.
Little C.H.A.D.
Gives kisses
A familiar who will drop a half red heart every 2 rooms.
Rotten Meat
HP up
Adds one heart container.
The Bible
Temporary Flight
Upon activation, Isaac gains flight, allowing him to pass over all obstacles in the current room. Instantly kills Mom, Mom's Heart, and It Lives when activated, but will kill Isaac when activated while fighting Satan.
Ghost Baby
Spectral buddy
Spawns a familiar that follows Isaac around and fires spectral tears.
Blue Cap
HP + tears up + shot speed down
Grants 1 heart container and increases tears, but decreases shot speed.
How to Jump
It's about time you learned how
Gives Isaac the ability to jump (over gaps, spikes, etc.).
Infestation 2
Infestation shot
Spawns allied blue spiders from killed enemies.
Lil Delirium
Delirious friend
Grants a familiar that transforms into another random familiar every 10 seconds.
Box
Stuff
Spawns 1 of each (non-collectible) item: 1 coin, 1 key, 1 bomb, 1 heart, 1 card, 1 pill, 1 trinket.
Guppy's Collar
Eternal Life?
Grants Isaac a permanent 50% chance to respawn with 1/2 of a red heart after death.
Charged Baby
Bbbzzzzzt!
A familiar that drops a Little Battery every 4 rooms. Has a small chance to freeze all enemies in the room when hit.
IV Bag
Portable blood bank
Upon activation, Isaac loses a half-heart (one whole heart in The Womb onwards) for a random amount of coins, similar to the blood donation machine.
Champion Belt
DMG + Challenge Up
Increases damage, but also increases the chance of champion enemies appearing.
Mom's Underwear
Range up
Increases range.
More Options
There are even more options!
Two items spawn in every Treasure Room. Only one can be taken; the other will disappear.
Stigmata
DMG + HP up
Increases damage, and adds 1 heart container.
Demon Baby
Auto-turret friend
Follows Isaac and automatically fires at enemies in its reach.
SMB Super Fan
All stats up
Increases all stats.
Pentagram
DMG up
Increases damage and increases the chance for a Devil or Angel Room to appear.
Obsessed Fan
Follows my every move...
A purple fly familiar that follows Isaac's movements on a 3 second delay and deals contact damage to enemies.
Halo of Flies
Projectile protection
Spawns two pretty fly familiars that block enemy shots and deal contact damage to enemies.
Polyphemus
Mega Tears
Makes Isaac shoot one huge tear. Also reduces Tears to minimum. Damage increased . If tear does more damage than an enemy's life, the tear continues to travel with the extra remaining damage.
Dead Cat
9 lives
Sets the amount of red heart containers to 1, but gives Isaac 9 extra lives. After dying, Isaac is teleported to the last safe room. New heart containers can be obtained after picking up this item, but after each death, the number of heart containers is set to 1 again.
Squeezy
Tears up
Increases tears by 0.4, and spawns 2 Soul Hearts pickups.
The Nail
Temporary demon form
Adds one soul heart and allows the breaking of rocks and damaging enemies by simply walking over them. Increases damage and decreases speed. All effects except for the Soul Heart wear off upon leaving the room.
Angry Fly
He's violent
Spawns a fly familiar that orbits around a random enemy and deals 5 damage per tick to enemies it comes in contact with.
Soy Milk
DMG Down + Tears Way Up
Tears shrink and do much less damage, but fire in very rapid succession.
Hallowed Ground
Portable sanctuary
Spawns a white poop familiar, which turns into a white poop when Isaac is hurt.
Brown Nugget
Friendly fly
Spawns a stationary fly familiar that fires tears at nearby enemies.
Deck of Cards
Reusable Card Generator
Gives Isaac a random Tarot Card.
Brittle Bones
Everything hurts
Replaces all red hearts with 6 empty bone hearts. Upon losing a bone heart, Isaac fires bones in 8 directions and permanently gains a tears up.
Ipecac
Explosive shots
Replaces tears with explosive and poisoning projectiles fired in an arc from the mouth.
Deep Pockets
More stuff to carry!
Allows Isaac to carry two cards or pills (or a combination of both) at the same time.
Harlequin Baby
Double shot buddy
Spawns a familiar that follows Isaac around and fires two tears at once in a V-pattern.
Bomber Boy
Explosive blast!
+5 bombs. Isaac's bombs will now explode in a large cross-shaped pattern (roughly 5 bombs explosions wide). This also affects player-spawned troll bombs.
Mystery Egg
Sacrificial insemination
Spawns an egg familiar, which cracks and turns into a random friendly enemy when Isaac is hurt. The egg regenerates upon entering a different room.
Jesus Juice
Damage + range up
Increases Damage and Range.
Mama Mega!
BOOOOOOOOOM!
Damages all enemies and destroys all obstacles. The effect occurs every time a new room is entered for the rest of the floor. Opens doors to the floor's secret and super secret rooms.
Box of Spiders
It's a box of spiders
Summons 2-4 blue spiders.
Friend Zone
Friendly fly
A white orbiting fly which deals 3 contact damage per tick to enemies. This familiar orbits Isaac at a middle length distance somewhere between Distant Admiration and Forever Alone.
Tech X
Laser ring tears
Tears are replaced with laser rings that pierce through enemies and deal damage to enemies within them. Can be charged to increase the size of the ring.
The Parasite
Split Shot
Isaac's tears split in two when they hit something.
Pupula Duplex
Wide shot
Transforms Isaac's tears into a wide arc shape which gives them a much larger hitbox. Gives Isaac spectral tears which allows them to travel through objects in the environment (i.e. rocks).
Mega Blast
Laser breath
Upon use, Isaac fires a laser similar to the one used by Mega Satan. This laser deals massive damage, lasts for approximately 15 seconds, and persists between rooms. Isaac is pushed backwards by the force of the laser while it is active.
Blood Clot
DMG + range up
Increases damage by 1 and range by 5 for tears fired from the left eye.
Tarot Cloth
I see the future
Drops a random card or rune. Doubles the effects of cards and runes.
Eye of Belial
Possessed tears!
Grants piercing tears. After piercing one enemy, tears start homing and deal double damage.
Sticky Bombs
Egg sack bombs!
+5 bombs. Bombs stick to enemies and spawn 2-4 blue spiders if they kill an enemy.
Fast Bombs
Rapid bomb drops
Grants 7 bombs and allows bombs to be placed rapidly.
Car Battery
Double charge!
Causes Isaac's activated item to activate twice on each use.
Book of Shadows
Temporary Invincibility
Upon use, creates a protective shield nullifying all types of damage for 10 seconds.
Kamikaze!
Become the bomb!
Creates an explosion in the same area as Isaac, dealing half a heart of damage to him and also damaging all enemies caught in the blast radius.
Dataminer
109
Displaces enemy sprites for the current room, randomly increases one stat and decreases another.
Dark Prince's Crown
Loss is power
Increases range, tears, and shot speed when at exactly one red heart.
D20
Reroll the basics
Rerolls all pickups in the current room.
BBF
Big Beautiful Fly
Spawns a familiar that flies around the room in a manner similar to the Boom Fly and explodes on contact with an enemy. Respawns after ten seconds.
D8
Reroll stats
Re-rolls Isaac's speed, range, tears, and damage.
Mega Bean
Giga fart!
When used, the Mega Bean will freeze all enemies in the current room for a couple of seconds, deal 5 damage and poison any enemies near Isaac, and send a wave of spikes that deals 10 damage across the room in the direction Isaac is facing.
Curse of the Tower
You feel cursed...
Causes Isaac to spawn 6 troll bombs on the floor every time he gets hit, similar to the Anarchist Cookbook mechanic.
The Mark
DMG up
Increases Damage and Speed, plus adds one Soul Heart.
Cricket's Body
Tears up + splash damage
Grants -1 Tear Delay and reduces Range. When tears hit an object or deplete their range, they spawn 4 smaller tears, whose Range and Damage scale with Isaac's.
Spider Mod
Mod buddy!
Displays Isaac's tear damage and enemy health bars. Spawns a gray spider familiar that wanders around and inflicts a random status effect on any enemies it comes into contact with. Occasionally spawns a blue spider upon clearing a room.
The Mind
I know all
Grants the combined effects of the Blue Map, Treasure Map, and The Compass, revealing the floor layout and all special rooms, including Secret Rooms and Super Secret Rooms.
Binky
Memories...
Tears up, adds 1 soul heart, and decreases Isaac's size.
Telekinesis
Power of the mind
Upon use, for the next two seconds, any enemy shots that come near Isaac are held in place. After the charge is depleted, they are fired back as tears.
The Mulligan
They grow inside
Tears have a 1/6 chance of spawning allied blue flies when they hit an enemy.
Crown of Light
The untainted gain power
Gives Isaac a crown that glows blue when active, and turns gray when inactive. While Isaac has no empty red heart containers, Isaac's tears are replaced with blue diamond tears that deal double damage. Regardless of health, the crown will deactivate for the current room when Isaac takes damage.
The Ladder
Building bridges
Allows Isaac to walk across gaps one square across by automatically placing a ladder between the two walkable sections.
The Wafer
Damage resistance
All sources of damage that would cause more than one half heart of damage are reduced to one half heart instead.
Depression
:(
Spawns a cloud familiar that leaves a trail of tears that damages enemies. Has a chance to spawn damaging beams of light onto enemies that touch the cloud.
The Soul
I am all
Grants two soul hearts. Isaac now repels enemy projectiles.
Book of the Dead
Rise from the grave
Upon use, spawns a friendly Bony or an orbital bone for each enemy killed in the current room.
Magneto
Item snatcher
Pulls pickups towards Isaac.
Papa Fly
Turret follower
A blue fly familiar follows Isaac's movements on a 3 second delay. Papa Fly will fire tears at nearby enemies.
Key Bum
He wants your keys!
Spawns a portable key master that follows Isaac and collects keys, giving random chests in return.
Fruit Cake
Rainbow effects!
Isaac's tears gain a random effect that changes every shot.
Wait What?
I can't believe it's not Butter Bean!
Isaac farts, sending out rock waves.
<3
HP up
Grants Isaac one red heart container and fully restores Isaac's health.
Mom's Contacts
Freeze effect
Adds a chance to shoot petrifying tears, which stop enemies in place and prevent them from moving or attacking. Range up.
Cambion Conception
Feed them hate
After taking damage a certain amount of times, a permanent demonic familiar spawns.
Bozo
Party time!
Increases damage by a flat 0.1 and grants a soul heart. Enemies can randomly become briefly charmed or feared. Taking damage has a chance to spawn a rainbow poop.
Samson's Chains
The ol' ball and chain
Pull a chain and ball behind you that will damage enemies on contact and is able to break stones.
Butter Bean
Reusable knock-back
Isaac farts and pushes back nearby enemies.
Slipped Rib
Projectile shield
Spawns a bone familiar that circles around Isaac and reflects enemy shots.
Acid Baby
Pills pills pills!
Spawns a familiar that drops random pills every 2 rooms cleared. Upon using a pill, all enemies in the room are poisoned.
Breath of Life
Invincibility at a cost
Grants a brief moment of invincibility when the charge bar hits zero. If spacebar is held for an additional second after hitting zero, Isaac will take damage.
Boom!
10 bombs
Grants 10 bombs.
Head of Krampus
Krampus Rage
Fires a cross-patterned brimstone shot, just like The Fallen and Krampus shoot.
Goat Head
He accepts your offering
A Devil Room / Angel Room Door will always spawn after every boss fight, excluding the first floor and floors after Utero II/Womb II.
Forever Alone
Attack fly
Spawns a blue attack fly that orbits a long distance from Isaac.
Sharp Straw
More blood!
Damages all enemies in the room.
Chemical Peel
DMG up
Tears fired from left eye do increased damage.
Mom's Eyeshadow
Charm tears
Tears have a chance to charm enemies.
Polydactyly
Hold me!
Allows Isaac to carry two cards, pills, or any combination of both at the same time. Drops a random card or pill.
Dad's Ring
Father's blessing
Creates a ring of light around Isaac that petrifies enemies in contact.
Duality
You feel very balanced
Whenever a Devil or Angel Room would spawn after defeating a boss, both rooms spawn. Only one can be entered.
Fate's Reward
Your fate beside you
A blue head familiar that will follow Isaac and fire tears copying his tear effects and damage.
Continuum
Transcendent tears
+2.25 Range Up. +1.5 Tear Height. Isaac's tears travel through walls and appear out of the opposite wall. Isaac's tears also travel over rocks and objects.
Celtic Cross
You feel blessed
Grants a chance to trigger the Book of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 7 seconds.
Lead Pencil
He's a bleeder!
After every 15 tears fired, Isaac will fire a high-damage cluster of tears.
Lil Haunt
Fear him
A familiar that damages enemies by chasing them as well as inducing the fear effect.
Placebo
Pill mimic
When used, copies the effect of the pill Isaac is currently holding without consuming it. Does not copy the effects of cards or runes.
Growth Hormones
Speed + DMG up
Increases damage by 1 and speed by 0.4.
D1
What will it be?
Duplicates a random pickup in the room.
Farting Baby
It farts!
A familiar that follows Isaac and blocks tears. If a tear hits Farting Baby, there is a high chance for it to fart, which will either knock back, poison, or charm all nearby enemies.
Athame
Call to the void
Whenever Isaac takes damage, a black ring briefly appears around Isaac, dealing damage to all nearby enemies.
Spear of Destiny
Your destiny
In addition to tears, Isaac now holds a spear in front of him which deals damage equal to 2 times his tear damage, and occasionally inflicts fear. The spear cannot be thrown, but deals damage while it is in contact with an enemy.
Crack Jacks
Don't swallow the prize!
Adds one heart container and drops a random trinket.
Sulfuric Acid
Acid tears!
Increases damage. Adds a chance to fire acidic tears which can destroy obstacles.
Maw of the Void
Consume thy enemy!
+1.0 Damage Up. After continuously firing tears for 2.5 seconds, a red cross appears on Isaac's head that, upon releasing the fire button, creates a black ring that rapidly deals damage equal to Isaac's tear damage to any enemies in contact with it.
Glass Cannon
Be gentle...
When used, reduces Isaac's health to half a heart (including soul and black hearts) and fires one large piercing spectral tear that does a lot of damage. The damage done by Glass Cannon scales with Isaac's damage (at base damage it does 45 damage).
Technology Zero
Static tears!
Connects Isaac's tears with electricity that can damage enemies.
Treasure Map
Full visible map
Reveals all rooms for every floor. However, it does not reveal icons or secret rooms.
???'s Only Friend
Controlled friend
Summons a big attack fly that can be controlled with the shooting direction-keys.
Little Gish
Sticky friend
Spawns a familiar that follows Isaac around and fires slowing tears, impeding enemies' speed.
Sister Maggy
Friends 'till the end
A familiar that follows Isaac around shooting blood tears.
Spelunker Hat
See-through doors
Reveals type of adjacent rooms, including location for secret rooms and super secret rooms.
Dessert
HP Up
Grants Isaac one full red heart container.
Smelter
Trinket melter!
Consumes Isaac's currently held trinket and applies its effect permanently.
Number One
Tears up
+1.5 tears, -17.62 range
Guppy's Paw
Soul converter
Removes one red heart container in exchange for gaining 3 Soul Hearts.
Notched Axe
Rocks don't stand a chance
Isaac holds the axe above his head for as long as the spacebar button is held (or until he leaves the room). While holding the axe, Isaac can break any rock he touches, but cannot attack or pick up other items.
Hive Mind
Giant spiders and flies
Increases the size of blue spiders and blue flies and doubles the amount of damage they deal.
Leo
Stompy
Allows you to crush rocks when you walk over them.
Mr. ME!
Caaan do!
Summons a controllable ghost that can perform various tasks depending on what it targets.
Lemon Mishap
Oops...
Creates a small yellow pool of creep, which damages enemies that cross it.
The Wiz
Double wiz shot!
Tears simultaneously fire out of both eyes diagonally, similar to the effect of the R U A Wizard? pill. Isaac's tears also travel above all obstacles.
Zodiac
The heavens will change you
Zodiac will give Isaac a random zodiac item effect that changes after every floor.
A Quarter
+25 coins
Adds 25 to Isaac's coin count, capping at 99.
The Halo
All stats up
Grants one Heart Container, +0.3 Damage, +0.2 Tears, +0.25 Range, +0.3 Speed, and +0.5 Tear Height.
The Book of Sin
Reusable Item Generator
Spawns a random pickup, pill, card, or trinket.
Unicorn Stump
You feel stumped
Upon use, grants invulnerability and increased speed for five seconds, but removes the ability to shoot tears.
Whore of Babylon
Curse up
Increases damage and speed whenever Isaac has half a red heart or less (one red heart for Eve), ignoring any soul or black hearts.
The D6
Reroll Your Destiny
Allows Isaac to re-roll collectible items in the current room into other items, depending on the current room's Item Pool.
Mom's Perfume
Fear shot
Adds a chance to shoot fear tears and decreases tear delay by 1.
Missing Page 2
Evil up. Your enemies will pay!
Gives 1 black heart. Upon taking damage that reduces Isaac's health to one heart or less, activates The Necronomicon effect, dealing 40 damage to all enemies in the room.
Speed Ball
Speed + shot speed up
Increases speed by 0.3 and shot speed by 20%.
Mom's Eye
Eye in the back of your head
Allows Isaac to fire tears from the back of his head.
Eden's Soul
...
Spawns two item pedestals.
Magic 8 Ball
Shot speed up
Increases Shot Speed, and drops a Tarot Card when picked up.
Technology 2
Laser
Decreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously.
Headless Baby
Bloody Friend
Familiar that follows Isaac, leaving blood creep on the ground.
Scatter Bombs
We put bombs in your bombs!
Adds 5 bombs. Isaac's bombs explode into 2-4 tiny bombs.
Marked
Directed tears
Isaac will now fire tears automatically directed at a red target on the ground which is controlled by the player. This allows for a full 360 degree tear firing radius. Can be overridden by other tear modifiers such as Mom's Knife or Brimstone.
Large Zit
Creep shots
Adds a chance to fire a creep shot that deals double damage and leaves a trail of slowing white creep.
Torn Photo
Tears + shot speed up
Tears + Shot speed up.
Varicose Veins
I'm leaking...
Taking damage releases a ring of 10 high damage tears.
Bursting Sack
Spider love
Spider enemies no longer target or deal contact damage to Isaac.
Ceremonial Robes
Sin up
Adds 3 black hearts and increases Damage by 1.
Bum Friend
He's greedy
A portable beggar who follows Isaac, picks up coins for himself, and occasionally drops a pickup after collecting a coin. Does not spawn collectibles.
Lazarus' Rags
Eternal Life?
Upon dying, resurrect as Revived Lazarus with one heart container and Anemic item.
Old Bandage
HP up
Adds one empty heart container. Whenever Isaac takes damage there's a chance that a Red Heart may drop.
Mine Crafter
Booom!
When used, places an explosive TNT barrel that can be pushed and used to destroy rocks or damage enemies. If used a second time in the same room while the previous TNT barrel is still intact, it will remotely explode the TNT.
Trinity Shield
"You feel guarded"
Isaac gains a shield that protects him from enemy shots.
Tonsil
Gross...
Grants a familiar that can block enemy shots.
Finger!
Watch where you point that!
Spawns a finger familiar that points at enemies, dealing constant damage.
Rosary
Faith up
Adds 3 Soul Hearts and increases the chance for The Bible to appear in any item pool.
Multidimensional Baby
ydduB Buddy
Spawns a familiar that will follow Isaac's movements on a 2.5 second delay. Tears that pass through the baby will be doubled and increase in speed.
Mystery Gift
Wrapped up nice for you!
Upon use, spawns a random item from the current room's item pool, with a chance to spawn A Lump of Coal or The Poop instead.
Teleport
Teleport!
Teleports you to a random room on the level.
Rune Bag
Rune generator
A bag that follows Isaac and drops a random rune every 3 rooms.
Black Candle
Curse immunity + evil up
Prevents curses. Grants one black heart. Increases the chance for a Devil or angel room to appear.
Contagion
Outbreak!
The first enemy killed in a room explodes and poisons nearby enemies. Poisoned enemies will also explode upon death.
D7
Reroll rewards!
Restarts the current room and brings back all enemies, allowing more rewards to be acquired by completing the room.
Coupon
Allow 6 weeks for delivery
Upon use, makes a random item from a shop, devil deal, or black market free.
Iron Bar
Concussive tears
Increases damage by 0.3 and adds a chance to shoot concussive tears, causing enemies to walk around randomly.
Anarchist Cookbook
Summon bombs
Spawns six troll bombs around the room.
Mom's Pearls
Range + luck up
+1.25 Range Up. +0.5 Tear Height. +1 Luck Up.
Mom's Purse
More trinket room
Allows Isaac to hold 1 additional trinket.
Pause
Stop!
Freezes all enemies until a fire button is pressed.
Cancer
HP up + you feel protected
Adds 3 soul hearts. Grants The Wafer effect for the current room upon taking damage.
Robo-Baby 2.0
We worked out all the kinks
Fires lasers at any enemy in its line of sight and moves based on the direction Isaac is firing tears.
Odd Mushroom
Fire rate up
+1.7 tears, +0.3 speed, reduces damage.
Anti-Gravity
Antigravity tears + tears up
-2 Tear Delay. Tears float in position until firing ceases, after which they will fly off in the direction they were shot in.
Money = Power
$$$ = DMG
Increases damage by 0.04 for every coin Isaac has, up to +3.96 damage at 99 coins.
Chaos
!!!
Chaos causes items to be chosen from random item pools. When picked up, drops between 1-6 random pickups on the floor.
Ghost Pepper
Flame tears
Adds a chance to shoot a fire that damages enemies and remains in place until it deals enough damage or the room is left.
Placenta
HP up + regen
Grants a full heart container, and a chance to regenerate a half-heart of health every minute of gameplay.
Lord of the Pit
Demon wings
Grants flight and increases speed.
Dull Razor
I feel numb...
Hurts Isaac without depleting health, activating any items that trigger upon taking damage.
Camo Undies
Camo kid
Isaac becomes camouflaged at the beginning of each room. Enemies will not attack Isaac until he starts firing tears.
Belly Button
What's in there?
Drops a random trinket. Grants a second trinket slot.
Lil Monstro
Ain't he cute?
Spawns a familiar that fires clusters of tears. Must be charged before shooting.
Dad's Lost Coin
I remember this...
Increases range by 1.5. Drops a lucky penny.
Virgo
You feel refreshed and protected
Grants a chance to trigger the Book of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 10 seconds. Also converts "bad pills" into "good pills".
Tech.5
It's still being tested...
Grants a unlimited range piercing laser with random rate of fire that does not replace tears. The laser might occasionally fire with the effect of a random item or trinket, such as Hook Worm, Spoon Bender or Tiny Planet.
Key Piece 2
???
Combined with Key Piece 1, unlocks the golden gate in the starting room of The Chest and Dark Room to fight Mega Satan.
The Inner Eye
Triple shot
Grants triple shot but decreases tears.
Missing No.
Syntax error
Randomizes all passive items upon pickup and at the start of each succeeding floor.
The Bean
Toot on command
Isaac releases bad gas, poisoning any enemy in close vicinity.
Backstabber
Watch your back!
Has a chance to fire tears that inflict bleeding on enemies, causing them to slowly take damage over time.
Magic Scab
HP + Luck up
Increases luck and HP by 1.
Stem Cells
HP up
Adds one filled heart container and increases Shot Speed.
Shade
It follows
Spawns a shadow familiar that follows Isaac's movements on a 1 second delay and deals contact damage to enemies.
Milk!
Don't cry over it...
A glass of milk follows Isaac and spills on the floor upon taking damage. After the milk spills, Isaac's tear delay is decreased by 2 for the rest of the room.
A Pony
Flight + Dash Attack
Passively grants flight and increased speed. Upon use, Isaac charges in the direction the pony is facing, becoming invulnerable during the charge and damaging enemies.
Aries
Ramming speed
+0.25 Speed. Running into enemies while at a high speed will deal 18 points of damage. Does not prevent contact damage.
Guppy's Head
Reusable fly hive
Spawns 2-4 blue flies to damage enemies.
Latch Key
Luck up
Increases Luck by 1, grants 1 Soul Heart and spawns 2 Keys.
Mom's Shovel
Lost but not forgotten
Spawns a trapdoor that leads to the next floor upon activation. Unlocks The Forgotten when used on a mound of dirt that appears in The Dark Room.
Mr. Boom
Reusable bomb buddy
Drops a large bomb.
Big Chubby
Chub chub
Spawns a familiar that slowly charges forward and damages enemies in its path.
Sprinkler
Sprinkles.
Upon use, spawns a sprinkler that rotates and fires tears.
1up!
Extra life
Gives an extra life. Upon death, you will respawn in the previous room with full health and lose the 1up!.
Cricket's Head
DMG up
Increases damage by 0.5, and multiplies it by 1.5x.
Lost Contact
Shielded tears
Every tear has a small shield which will allow it to block one enemy projectile.
Synthoil
DMG up + range
Increases damage by 1, range by 5.25, and tear height by 0.5.
Mr. Dolly
Range + tears up
Tears and Range up. Spawns 3 random types of hearts on the floor when picked up.
Friendly Ball
Gotta fetch 'em all!
Throwing the ball at an enemy instantly kills it and captures it. The captured enemy can later be released and will be friendly, fighting for Isaac and persisting between rooms.
Kidney Stone
Matt's kidney stone
Randomly while firing tears, Isaac will stop firing and turn red, where he will charge and release a lot of 'tears' in one go. In the burst of tears is a kidney stone which deals a lot of damage.
The Gamekid
Temporary Man-Pac
Upon use, turns the character into a into a Pac-Man-like creature for 5 seconds, granting invulnerability, inflicting fear on all enemies, and replenishing half a red heart container for every two enemies killed.
Moldy Bread
Midnight snack!
Grants one full red heart container.
Bumbo
Bumbo want coin!
Spawns a beggar familiar which floats around the room and picks up any nearby coins, leveling up after collecting several coins. At level 2, Bumbo gains a body. At level 3, it begins to fire tears. At level 4, Bumbo chases enemies slowly, dealing contact damage.
Succubus
Damage booster
Spawns a flying familiar that bounces around the room with a black aura, dealing rapid damage to any enemies inside it. While standing in the aura, Isaac gains a 1.5x tear damage multiplier.
Death's Touch
Penetrative shot + damage up
Increases Damage by 1.5, reduces Tears by 0.3 and increases tear size. Grants piercing tears. Tears are replaced by Death's scythes, which is a cosmetic effect only.
God's Flesh
Shrink shot
Tears now have a random chance to apply a shrinking effect, causing enemies to shrink in size and also run away from Isaac. Shrunk enemies can be crushed and killed by walking over them.
Censer
Peace be with you
Gives Isaac a golden censer familiar which creates a huge aura of light that slows down any enemies and enemy shots inside it.
Cone Head
Hard headed!
Grants a soul heart. Adds a chance to block enemy shots.
Rainbow Baby
Random buddy
Spawns a familiar that follows Isaac around and fires tears with random effects.
Pop!
Eyeball tears!
Replaces Isaac's tears with eyeballs that can bounce off of each other. The eyeballs are not limited by range, and will instead dissipate when they stop moving or when hitting an enemy or obstacle.
Lil' Brimstone
Evil Friend
A Familiar that shoots a thin Brimstone beam. Must charge like Brimstone before shooting.
Holy Light
Holy shot!
Isaac has a random chance to fire a Holy tear, which, when it hits an enemy, will spawn a Crack the Sky-style light beam on the same enemy, dealing damage.
Leprosy
You're tearing me apart!
Upon taking damage, grants a body part as an orbital, which blocks enemy shots and deals 7 damage per tick to enemies it comes in contact with. The orbitals will be destroyed if they take enough damage from enemies or enemy shots.
Dead Eye
Accuracy brings power!
Isaac's damage increases each time an enemy is hit. Damage is reset upon missing a shot.
Anemic
Toxic blood
+5 range. After Isaac is damaged, a trail of red creep will be left behind Isaac until he leaves the current room.
Experimental Treatment
All stats up, then shuffled
Randomly increases and decreases some of the character's stats.
Loki's Horns
Cross Tears
Gives a random chance for projectiles to fire in all 4 cardinal directions.
Mr. Mega
Blast damage
Gives Isaac 5 bombs, and makes all dropped bombs larger, which have an increased blast radius and increased damage.
The Polaroid
Fate Chosen
If the character has half a red heart or no red hearts after taking damage, it triggers the Book Of Shadows effect, creating a shield that nullifies all types of damage for 5 seconds. Also allows entrance into The Chest.
Cupid's Arrow
Piercing shots
Grants Isaac piercing tears that travel through enemies (but not obstacles) instead of breaking on impact with them.
Sad Bombs
Tear blast +5 bombs
+5 Bombs. Upon exploding, bombs shoot 8 tears off in every direction, similar to Tammy's Head. The tears are affected by any tear modifiers Isaac has on his own tears.
Toothpicks
Tears + shot speed up
+0.7 tears, +16% shot speed.
Mom's Heels
Range up
Increases range.
Bomb Bag
Gives bombs
Isaac is followed by a small bag that drops a Bomb, 1+1 Free, or a Troll Bomb every 3 rooms.
BFFS!
Your Friends Rule!
Increases the size and damage of familiars.
A Dollar
$$$
Gives Isaac 99 coins. Can be found multiple times in a single playthrough.
Tear Detonator
Remote tear detonation!
When used, will detonate any tears currently on the screen and cause each one to split into 6 more tears which will fire in a circle, similar to Tammy's Head.
Euthanasia
Needle shot
Adds a chance to fire needles. If a needle kills an enemy, it bursts into more needles.
Stop Watch
Let's slow this down a bit
Automatically inflicts slow to all enemies in every room. Upon taking damage, inflicts slow to all enemies for the current room.
Poke Go
Gotta catch em...
Upon entering a room with enemies in it, has a chance to spawn a random friendly enemy that persists across rooms.
Spider Baby
Spider revenge
When hit, spawns up to 2 blue spiders.
Technology
Laser tears
Replaces tears with a piercing laser with unlimited range.
Mom's Pad
Gross...
Upon use, inflicts fear to all enemies in the room for 5 seconds.
Pyromaniac
It hurts so good +5 Bombs
Isaac heals 1 heart instead of taking damage from an explosive source. Adds 5 bombs.
Ventricle Razor
Short cutter
Can be used to place an orange portal and a blue portal. Upon entering a portal, Isaac is teleported to the other portal.
Bob's Brain
Explosive thoughts
Spawns a familiar that charges forward when shooting tears and explodes upon contact with an enemy, damaging and poisoning them. The familiar respawns after a few seconds.
Punching Bag
Scape Goat
Spawns a Mulligan Familiar that will wander the room randomly. Enemies will attack the Mulligan if it's closer.
Remote Detonator
Remote bomb detonation
Bombs you place explode only when you use this item. Gives 5 bombs.
???'s Only Friend
Controlled friend
Summons a big attack fly that can be controlled with the shooting direction-keys.
Dog Tooth
Bark at the moon!
Increases damage and speed. Upon entering a room adjacent to a secret room, a howl sound effect will play.
Best Bud
Sworn protector
When hit, summons a white attack fly similar to Distant Admiration for the current room.
Abel
Mirrored buddy
A familiar that mirrors the player's movements and shoots in the opposite direction.
Compost
Gain more friends!
Spawns a blue spider or fly. Turns pickups in the room into blue spiders or flies.
Lachryphagy
Feed them!
Isaac's tears decelerate as they travel. Upon stopping or hitting an obstacle, they burst into 8 tears in all directions. Tears can be fired into other tears to feed them, increasing their damage.
Abaddon
Evil + DMG up + fear shot
Increases damage and speed, removes all red heart containers, grants six black hearts, and adds a chance to shoot fear tears.
Super Bandage
+2 hearts
Grants one Heart Container and gives 2 Soul Hearts.
Piggy Bank
My life savings
Gives 3 pennies on pick-up. Every time Isaac is damaged, he will drop one additional penny.
Jacob's Ladder
Electric tears
Tears fire sparks of electricity in random directions upon hitting an obstacle or enemy.
Pisces
Tears up + knock-back shots
-1 Tear Delay, adds knock-back shots and increases tear size.
Holy Grail
Flight + HP up
Grants flight and one heart container.
Yum Heart
Reusable Regeneration
Restores 1 whole red heart.
Cat-O-Nine-Tails
Shot speed + damage up
Increases Shot Speed and damage.
Haemolacria
I'm seeing red...
Tears are now fired in an arc. Upon hitting the floor, an obstacle, or an enemy, they burst into many smaller tears in all directions. Increases tear delay.
Robo-Baby
Friends 'till the bbbbzzzt
Follows Isaac around, shooting enemies with an eye laser similar to Technology.
Delirious
Unleash the power!
Spawns a random charmed boss.
Mystery Sack
?
Spawns a familiar that follows Isaac around and has a chance to drop a heart, coin, bomb, or key after clearing a room.
Dead Bird
Protective buddy
Spawns a flying familiar for the current room that chases enemies whenever Isaac takes damage.
Guardian Angel
Extra protection
Spawns an orbital familiar that blocks enemy projectiles, deals contact damage to enemies, and increases the speed of all orbital familiars.
Greed's Gullet
Money = health!
Grants a heart container for every 25 coins Isaac has.
Restock
Never ending stores!
Causes shops to instantly restock their items when they are bought. Granted by default for every character in Greed Mode.
Sack Head
More sacks!
Greatly increases the chance to find sacks.
Black Lotus
HP up x3!
Grants the player one red heart container, one soul heart, and one black heart.
Adrenaline
Panic = power
Increases damage based on how many empty heart containers Isaac has.
Dead Onion
Toxic aura tears
Grants piercing and spectral tears. Increases tear size (without increasing damage) while greatly reducing range and shot speed.
Magic Mushroom
All Stats Up!
Increases most stats, enlarges Isaac, grants a heart container and restores all health.
Dad's Key
Opens all doors...
Opens all doors in the current room when activated, including doors which require a key to open and entrances to secret rooms. Opens the big doors in the first room of both The Chest and the Dark Room.
Parasitoid
Egg tears!
Adds a chance to fire an egg sack which spawns slowing creep and spawns a blue fly or spider upon hitting an enemy.
Dark Bum
He wants to take your life
Spawns a familiar that follows Isaac around and collects red hearts. For every one-and-a-half red hearts collected, Dark Bum will generate one soul heart, one hostile Spider or one friendly blue spider.
The Body
I feel all
Adds 3 heart containers.
D Infinity
Reroll forever
Grants a random dice item that changes each use.
Proptosis
Short range mega tears
Tears start out massive with high damage, and then shrink down and become weaker over a short range.
Lil Chest
What's in the box?
Spawns a chest familiar that follows Isaac and drops a random pickup every few rooms.
Dr. Fetus
???
Tears are replaced by bombs that benefit from bomb-enhancing effects and slide for a fixed time after being fired.
Analog Stick
360 tears!
+0.3 tears up. Allows Isaac to fire tears diagonally.
Epic Fetus
On-demand air strike
Isaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
The Pact
DMG + Tears UP
Increases damage by 0.5, tears by 0.7 and grants two soul hearts upon pickup.
D100
REEROLLLLL!
Upon use, rerolls all passive items on Isaac like the D4, every pedestal item in the room like The D6, and every pickup like the D20.
Marbles
Choking hazard
Spawns 3 random trinkets. Taking damage has a small chance to swallow Isaac's currently held trinket, gaining its effect permanently.
Taurus
Speed down + rage is building
Speed down; gains speed while in a room with enemies until gaining My Little Unicorn effect for a few seconds.
Mom's Lipstick
Range up
Increases range and shot height.
Circle of Protection
Protect me from myself
Surrounds Isaac with a large white halo. Once per second, the halo deals Isaac's tear damage to enemies inside it. It may also convert enemy shots entering the halo into friendly purple homing tears.
Sworn Protector
Protective friend
An orbital angel which does 7 contact damage per tick and blocks enemy shots. Upon blocking 10 shots in a room it drops an eternal heart.
Explosivo
Sticky bomb shot!
Isaac's tears have a chance to stick to enemies and explode.
The Poop
Plop!
Spawns a pile of poop where the character is standing and knocks nearby monsters back. May yield pickups like regular poop.
Monster Manual
Temporary buddy generator
Summons a random familiar for the current room. Can summon familiars not yet unlocked.
Evil Eye
Eye shot!
While firing tears, Isaac has a chance to fire an eye across the screen with a very slow shot speed, which will fire tears of its own in the same direction as Isaac. The eye will be destroyed if it comes into contact with an enemy or obstacle.
Midas' Touch
Golden touch
Enemies that touch you are stunned and turn gold. Any enemy killed while in this state will drop a coin.
The Compass
The end is near
Reveals all special rooms (except secret rooms of any kind).
Pandora's Box
??
Upon use, spawns certain pickups or items depending on the floor it is used on. Single-use.
Magic Fingers
Pay to play
For 1 coin, damages all enemies in the room.
Pyro
99 bombs
Adds 99 bombs.
Eve's Mascara
Shot speed down + DMG up
Doubles damage, halves tears stat, and greatly reduces shot speed.
Godhead
God tears
Increases damage and range while reducing tears and shot speed. Grants homing tears and tears gain a damaging halo.
Diplopia
Double item vision
Duplicates all pickups and item pedestals in the room.
Gemini
Conjoined friend
Suture becomes attached to Isaac, and does touch damage to enemies within its attacking range.
Monstro's Lung
Charged attack
Increases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.
Wire Coat Hanger
Tears up
Increases Tears by 0.7.
Steam Sale
50% off
Reduces all Shop prices by 50%, rounded down to 7 coins for an item, rounded up to 2-3 coins for a pickup.
Chocolate Milk
Charge shots
Grants charged tears that deal greater damage when fully charged.
Moving Box
Pack and unpack
If the box is empty, picks up all items and pickups in a room and stores them. If the box is not empty, places all stored items and pickups in the current room.
Glitter Bombs
Prize bombs!
Gives Isaac 5 bombs, and makes Isaac's bombs have a chance to drop random pickups or charm enemies when they explode.
Head of the Keeper
Penny tears!
Isaac's tears become coins and now have a chance to drop pennies on the floor upon successfully hitting an enemy.
The Necronomicon
Mass room damage
Damages all enemies in the room significantly.
Metal Plate
It itches...
Adds a chance to reflect enemy shots. Grants one soul heart.
Jaw Bone
Fetch!
Spawns a familiar that flies the room while firing, dealing a flat 7 damage to enemies that come in contact and retrieving pickups.
The Battery
Stores energy
Activated Items can be "overcharged" to allow for an additional use.
The Ludovico Technique
Controlled Tears
Instead of firing tears, Isaac controls one floating tear that hover over obstacles. This tear deals constant damage when held in place over an enemy.
My Reflection
Boomerang tears
Gives Isaac's tears a boomerang effect, and increases range and shot speed.
Ouija Board
Spectral tears
Grants spectral tears that travel through obstacles (but not enemies) instead of breaking on impact with them.
Forget Me Now
I don't remember
When activated, the level ends and is freshly regenerated with new rooms, monsters, and items. Disappears after use.
Guppy's Tail
Cursed?
Increases chance of finding gold chests and normal chests, but reduces chance of finding pickups.
Eucharist
Peace be with you
An Angel Room door will always spawn after every boss fight, excluding the first floor and floors after Utero II/Womb II.
Pointy Rib
Stabbing time
Spawns a bone familiar that can be aimed with the fire buttons and does contact damage.
Ankh
Eternal life?
Upon death, the player will respawn as ??? with 3 soul hearts.
Little Baggy
Extra pill room
Isaac can hold 2 pills at once and all cards are replaced by pills.
Roid Rage
Speed and range up
Increases speed by 0.6, range by 5.25, and tear height by 0.5.
Spider Butt
Mass enemy slowdown + damage
Damages all enemies in the room and slows them and their projectiles down.
Tractor Beam
Control your tears
Isaac emits a beam from his face. Isaac's tears travel in the path of the beam.
Contract From Below
Wealth... but at what cost?
Doubles the number of pickups and chests spawned after clearing a room or performing some other triggering action (such as using a blood donation machine), but reduces the chance for any pickups to spawn at all.
Lil Gurdy
A gurd of your own!
Gives Isaac a Gurdy familiar that will charge around the room dealing contact damage to enemies. Lil Gurdy is charged by holding down a fire button and letting go. The longer the button is held, the faster Lil Gurdy will fling itself across the screen. Lil Gurdy can pass over objects and obstacles in the room.
Book of Secrets
??????
Upon use, gives the effect of Treasure Map, The Compass, or Blue Map for the duration of the current floor.
Toxic Shock
Mass poison
Upon entering a room, poisons all enemies, dealing double Isaac's tear damage. Killing enemies leaves a small, short lasting pool of green creep on the ground.
Match Book
Evil up
Grants Isaac 1 Black Heart and 3 bombs. Can also give troll bombs.
Blank Card
Card Mimic
Has the same effect as the card or rune currently held by Isaac.
Apple!
Trick or treat?
Increases tears. Adds a chance to fire a high-damage razor blade.
The Sad Onion
Tears up
Increases Tears by 0.7.
No. 2
Uh oh...
Continuously firing tears for several seconds causes Isaac to drop a Butt Bomb. Butt Bombs explode for 60 damage like normal bombs, but also deal 10 damage to all enemies in the room and daze them for a short period of time.
Dead Tooth
Halitosis
While firing, Isaac gains a green aura that poisons nearby enemies.
Mom's Key
Less is now more +2 keys
Spawns 2 keys. Generates additional pickups from chests.
The Pinking Shears
Cut and Run
Separates Isaac's head and body for the current room. Isaac's head, which now has flight, will be under the player's control, while his body will seek out enemies to attack by contact damage.
Red Candle
Flame on
Throws a persistent flame that deals high damage and diminishes as it damages enemies or blocks shots.
Clicker
Change
Transforms Isaac into another random character.
Best Friend
Friends 'till the end
Deploys a decoy Isaac that eventually explodes with an increased blast radius.
Mom's Razor
It's sharp!
Spawns an orbiting razor that damages enemies it touches and inflicts bleeding on enemies, causing them to slowly take damage over time.
Little Horn
Science!
Adds a chance to fire a piercing tear that instantly kills any enemy that it touches.
Marrow
HP up?
Grants one bone heart and spawns three red heart pickups.
Holy Mantle
Holy shield
Automatically negates first taken damage in every room.
Fire Mind
Flaming tears
Grants flaming tears that deal burning damage over time. Tears have a chance to explode on impact with an enemy, which creates a fire at the location of the explosion.
Linger Bean
Crying makes me toot
Adds a chance to fire a gas cloud that damages nearby enemies.
Little Chubby
Attack Buddy
A familiar that charges forward and deals touch damage to any enemies in its path.
Divorce Papers
Tears up + you feel empty
Spawns a Mysterious Paper, increases tears, and grants a bone heart.
Portable Slot
Gamble 24/7
Upon activation, 1 coin will be consumed, and a random pickup may drop, similar to the slot machine.
Black Powder
Spin the black circle!
Isaac leaves a trail of black powder on the floor. Walking in a circle will spawn a pentagram symbol on the floor, which deals 10 damage per tick to any enemies inside it.
Lucky Foot
Luck up
+1 Luck. Increases chance of winning Shell Game Beggar. (Independent of luck stat)
Telepathy for Dummies
Temporary psychic shot
Upon activation, grants homing tears for the current room.
Mitre
You Feel Blessed
Grants a chance of converting any red hearts pickups into soul hearts instead.
There's Options
More options
There will be 2 items available to choose from after defeating a boss. Choosing 1 item causes the other to disappear.
Bloodshot Eye
Bloody friend
Spawns an orbiting eye familiar that fires tears every 2 seconds.
Isaac's Heart
Protect It
Isaac himself is now immune to all damage, and a heart familiar appears and follows Isaac. If the heart is hurt, Isaac is hurt.
Rotten Baby
Infested friend
A familiar that spawns blue flies.
Cursed Eye
Cursed charge shot
Grants charged tears that can be fired in a tight burst of four. Getting hit while charging will teleport Isaac into another room.
The Relic
Soul generator
Isaac is followed by a small blue cross that will drop a Soul Heart every 4 rooms.
Scorpio
Poison tears
Grants poison tears, which deal damage over time when inflicted.
Skeleton Key
99 keys
Sets your key count to the maximum of 99.
Bob's Rotten Head
Reusable ranged bomb
Upon use, Isaac holds a poison bomb which can be thrown towards any of the four cardinal points and explodes on impact.
Sacred Heart
Homing shots + DMG up
Increases damage and range while reducing shot speed and grants homing tears. Grants a Heart Container and replenishes all Red Hearts.
Bob's Curse
+5 poison bombs
Gives 5 bombs and grants all bombs poison effect.
The Boomerang
It will never leave you
Throws a short-range boomerang which does a bit of damage and has a high chance to stun the enemy for 2 seconds. Can also be used to grab pickups.
Monstro's Tooth
Summon Monstro
Monstro jumps onto a random enemy, doing area damage. Can damage/kill the player if summoned in an room without enemies.
Fanny Pack
It's filled with goodies!
Has a chance to drop a random pickup when Isaac takes damage.
Key Piece 1
???
Combined with Key Piece 2, unlocks the golden gate in the starting room of The Chest and Dark Room to fight Mega Satan.
Sack of Pennies
Gives money
Isaac is followed by a small bag that drops a coin every 2 rooms.
Leech
Blood sucker
Spawns a friendly familiar leech on the ground that hunts down enemies and heals you for half a heart each time it eats one.
Shoop Da Whoop!
BLLLARRRRGGG!
Fires a laser from Isaac's mouth.
Metronome
Waggles a finger
Grants a random item effect for the current room.
Crystal Ball
I see my future
Reveals the map (except the Super Secret Room) and drops a random Tarot Card or soul heart.
Bucket of Lard
HP up
Grants two empty heart containers and heals Isaac by half a heart, but decreases speed by 0.2.
Scissors
Lose your head
Upon use, turns Isaac's head into a stationary familiar for the current room which fires normal tears that deal 3.5 damage.
Glaucoma
Blind tears!
Adds a chance to shoot concussive tears, causing enemies to walk around randomly.
Mom's Wig
You feel itchy...
Adds a chance to spawn blue spiders when firing tears. Restores 1 red heart.
Sacrificial Altar
He demands a sacrifice
Upon use, sacrifices up to 2 familiars and spawns an item from the Devil Room Pool for each familiar sacrificed.
Dead Sea Scrolls
It's a mystery
Triggers the effect of a random activated item from a list of possible options (not every activated item is included).
Crooked Penny
50/50
Spawns a penny and has a 50% chance to double all items and pickups in the room. If the effect fails, the items and pickups disappear.
Butt Bombs
Toxic blast +5 bombs
Gives +5 bombs and makes all bombs Butt Bombs that fill the room with gas, damaging and confusing all enemies.
Serpent's Kiss
The kiss of death
Tears now have a random chance to apply a poison effect, causing 4 or 6 damage per tick to enemies (Similar to The Common Cold item). Isaac now deals poison damage on contact with enemies similar to The Virus item (Damage over time 4 or 6 per tick). Enemies that were poisoned have a chance to drop a black heart when killed.
Wooden Spoon
Speed up
Increases speed by 0.3.
Black Hole
Nothing can escape
Throws a black hole on the ground which sucks in and damages enemies.
Pay to Play
Money talks
This item turns all doors that require a single key into doors which need a coin to enter instead. This affects shops, item rooms and libraries.
Death's List
Just hope you're not next...
Grants a reward if all enemies in a room are killed in the order they are marked.
The Negative
Fate Chosen
If the character has half a red heart or no red hearts after taking damage, it triggers The Necronomicon effect, damaging all enemies in the room. Also allows entrance into the Dark Room.
Razor Blade
Feel my pain
Upon use, deals one heart of damage to Isaac and grants +1.2 damage for the current room.
PJs
You feel cozy
Grants four soul hearts and fully restores Isaac's red health.
Undefined
Undefined
Teleports Isaac to either the Secret Room, Super Secret Room, Treasure Room, or I AM ERROR.
Mom's Box
What's inside?
When used, Mom's Box will drop a random trinket on the ground. While held, increases luck by 1 and doubles the effects of trinkets.
Sinus Infection
Booger tears!
Adds a chance to fire a booger which sticks to enemies and poisons them.
Odd Mushroom
DMG up
Grants an empty heart container. Increases damage, range and shot height while reducing speed.
Prayer Card
Reusable eternity
Grants an eternal heart per use.
Steven
DMG up
Increases Damage by 1.
Jumper Cables
Bloody recharge
Grants an active item charge every 15 enemies killed.
Scapular
You have been blessed
Once per room, when Isaac is reduced to his last half red Heart, the aura around his head temporarily vanishes and he is granted one Soul Heart.
Mom's Bra
Mass Fear
Upon use, petrifies all enemies in the current room for approximately 4 seconds.
Bloody Lust
RAGE!
Increases damage as Isaac receives damage. Damage increase stays for the whole floor.
Lil' Loki
4-way buddy!
A Loki familiar that follows Isaac and shoots 4 tears in a cross pattern.
MEAT!
DMG + HP up
Adds a heart container and increases damage.
Mutant Spider
Quad shot
Grants quadruple shot but decreases tears.
20/20
Double shot
Grants double shot.
Maggy's Bow
HP up + you feel healthy
Gives one heart container and doubles the healing provided by red hearts.
Lunch
HP Up
Adds 1 heart container.
Screw
Tears and shot speed up.
+0.5 tears up, +0.2 shot speed up.
Plan C
Use with caution
Kills all enemies in the room, then kills Isaac three seconds later.
Isaac's Tears
Collected tears
Shoots 8 tears around Isaac, which retain the damage, shot speed, and special effects of his tears. Each tear shot by Isaac increases item charge by one.
Betrayal
Turn your enemy
Every time Isaac takes damage, a charm effect is applied to every enemy in the room, causing them to attack each other rather than Isaac.
The Virus
Poison touch
Inflicts poison to enemies who make contact with Isaac. Speed down.
Incubus
Dark friend
A demonic familiar that follows Isaac and shoots tears identical to Isaac's in terms of damage, range, fire rate, and effects.
Judas' Shadow
Sweet revenge
Adds an extra life; upon death, it respawns Isaac as Black Judas with only two black hearts.
Tammy's Head
Reusable tear burst
Shoots 10 tears in a circle around Isaac, which retain the damage, shot speed, and special effects (such as poison) of Isaac's tears.
Blanket
You feel Safe
Grants one soul heart. Upon entering a boss room, grants a shield that blocks one hit, then disappears.
Skatole
Fly love
All types of fly except Boom Fly and Red Boom Fly become passive and slowly move towards Isaac. Does not prevent contact damage.
Strange Attractor
Magnetic tears
Pickups, trinkets, and monsters are magnetically attracted to Isaac's tears.
Bobby-Bomb
Homing bombs!
Gives Isaac 5 Bombs, and causes all dropped bombs to home towards the closest enemy.
My Little Unicorn
Temporary badass
Upon use, grants invulnerability and increased speed for five seconds, removing the ability to shoot tears and replacing it with the ability to deal contact damage to enemies.
Rubber Cement
Bouncing tears
Tears bounce off walls, enemies, and environmental objects.
9 Volt
Quicker charge
Reduces the charge of any Activated Items by 1. Any 1 charge items instead have timed recharges.
Charm of the Vampire
Kills heal
Heals the character for half of a red heart for every 13 monsters killed.
Libra
You Feel Balanced
Gives 6 coins, 6 bombs, and 6 keys and balances out all attributes.
Cain's Other Eye
Near sighted friend
Spawns a familiar that floats slowly around the room on a zig-zag pattern similar to The Peeper and shoots normal tears in the same direction as Isaac.
Pageant Boy
Ultimate grand supreme
Spawns several coins around Isaac.
Juicy Sack
Sticky babies
A familiar that follows behind Isaac. It drips a trail of creep, which slows enemies, and spawns 1-2 blue spiders after each room.
PHD
Better pills
Converts all bad pills into good pills, spawns one pill pickup and restores health. Identifies all pills upon pickup.
Blood of the Martyr
DMG up
Increases Damage by 1, and turns Isaac's tears into blood tears.
White Pony
Flight + holy death
Passively grants flight and increased speed. Upon use, Isaac charges in the direction the pony is facing, becoming invulnerable during the charge and damaging enemies while also casting the effect of Crack the Sky.
Lusty Blood
Their blood brings rage!
Each time Isaac kills an enemy, Isaac's damage increases for the current room.
Buddy in a Box
What could it be?!
Grants a familiar with a random tear effect. The familiar is randomized at the start of each floor.
Teleport 2.0
I-Teleport!
When used, teleports Isaac to a random room that has not been explored yet. If all rooms are explored, including secret rooms, it will teleport Isaac to the Devil or Angel room. If all rooms are explored, including the Devil or Angel room, it will teleport Isaac to the I AM ERROR room. If used in a room with enemies, it will teleport Isaac out and back into the exact same room.
Box of Friends
Double your friends
Upon use, duplicates all of Isaac's familiars for the current room.
The Black Bean
Toot on touch
When taking damage, Isaac farts, causing poison damage to all enemies in range.
Infamy
Damage Reduction
Chance to block projectiles coming from any direction.
Schoolbag
Extra active item room
Allows Isaac to hold two active items.
Mysterious Liquid
Toxic Splash Damage
Tears leave a small, short lasting pool of creep on impact or when their range is depleted.
The Candle
Reusable flame
Throws out a blue flame that can pass over gaps (but not through rocks). The flame damages anything in its path.
Blood Bag
HP up
Grants one red heart container, restores 5 red hearts, and increases speed by 0.3.
Crack the Sky
Holy white death
Summons multiple beams of light in random locations around the room, dealing a large amount of damage to any enemy that touches them.
Epiphora
Intensifying tears
Shooting in one direction increases Isaac's rate of fire until the cap is reached. As soon as Isaac changes direction or stops shooting, rate of fire is reset to its normal amount.
King Baby
Lord of the dead!
Spawns a familiar that follows Isaac and makes other familiars follow it. While firing tears, it stops moving.
Kidney Bean
Love toots!
Upon use, Isaac farts, charming all nearby enemies.
Lil Spewer
Puking buddy
Spawns a random pill, and grants a small Spewer familiar that charges up and fires different types of creep.
Broken Shovel
It feels cursed
One of two parts necessary to create Mom's Shovel.
Sack of Sacks
Gives sacks
Spawns a sack familiar that has a chance to drop a sack upon clearing a room.
Satanic Bible
Reusable Evil
Upon activation, Isaac gains a black heart.
Brimstone
Blood laser barrage
Tears are replaced by a laser beam that pierces through all enemies and obstacles in its path and deals high damage. Can only be fired after a short charge-up period.
Raw Liver
HP up
Grants 2 Heart Containers and completely restores health.
The Peeper
Plop!
Spawns a familiar that floats slowly around the room on a zig-zag pattern similar to Boom Flies damaging enemies it passes through.
Glowing Hour Glass
Turn back time
When used, this item will rewind time, put Isaac back in the previous room, and undo anything that happened in the current room. Any health, pickups, or items gained or lost will be reset back to the previous state.
Void
Consume
Consumes all pedestal items in the room. Active items will have their effects added to Void, and passive items will grant stat upgrades.
A Snack
HP up
Grants one full red heart container.
The Book of Belial
Temporary DMG up
Upon use increases damage by 2 for the current room and by a further +50% if the character also has the Blood of the Martyr. Guarantees a Devil Room or Angel Room will be open after beating a boss while holding it, or increases the chance by 12.5%.
D4
Reroll into something else
Rerolls all of Isaac's items.
Blue Map
Secrets
Shows secret and super secret room locations on the map.
Daddy Longlegs
Daddy's love
Daddy Long Legs' shadow follows Isaac and stomps on enemies.
Mongo Baby
Mongo Friend
Summons a familiar that copies the tears of Isaac's other familiars.
Seraphim
Sworn friend
An angel familiar which follows Isaac and fires homing tears which deal 10 damage at -25% shot speed and a reduced fire rate.
GB Bug
Game breaking bug, right away!
A glitch familiar that bounces around the room and applies a random status effect to any enemies it comes into contact with and has a chance to re-roll pickups that it passes over.
Flat Stone
Skipping tears
Tears bounce off the floor. Tears that hit an enemy after bouncing deal splash damage to all nearby enemies for 25% of Isaac's tear damage.
Guillotine
An out-of-body experience
Isaac's head is removed from his body and floats around him. Increases Damage by 1 and grants -1 Tear Delay.