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- Spawns the last pill you used. pants, under wear, pink, knickers, moms underwear, mom underwear, REPENTANCE - Touching enemies deals 12 damage to them, Item Pool: Boss Room, Challenge Room, Mom's Chest, * dungeon room, blood challenge room, arena pool, boss room pool, boss room item, red, high, shoe, moms heels, mom heels, Drops a random heart on the floor when picked up, * moms lipstick, mom lipstick, dungeon room, blood challenge room, arena pool, boss room pool, boss room item, red, grey, gray, UNLOCK: Unlock this item by beating Mom's Heart 4 times, Gives Isaac angel wings for the current room, allowing him to fly, Instantly kills the Mom's Foot, Mom's Heart and It Lives boss fights, If used during the Satan fight, The Bible will instantly kill Isaac, Counts as 1 of 3 angel items needed towards the Seraphim transformation, Counts as 1 of 3 book items needed towards the Bookworm transformation, REPENTANCE - Reduced to 4 room recharge time, * library pool, library room, book room pool, angel room pool, god room pool, angel room item, They also retain most of your bomb synergizing items, This item causes your bombs to stick to enemies and when exploding will leave white creep on the ground which slows enemies, When one of your bombs kills an enemy, a bunch of blue spiders are spawned to fight by your side, which deal x2 your current damage, Item Pool: Item Room, Greed Mode Item Room, Bomb Beggar, Bomb Beggar, Shooting in one direction increases your fire rate until a cap is reached, The maximum effect is to halve your delay, which takes roughly 10 seconds to achieve, The accuracy of your tears is also reduced as your fire rate increases, As soon as you change firing direction, your fire rate is reset to its normal amount, Tears will now travel through walls and appear out of the opposite wall, similar to a portal-type mechanic, Your tears can now also travel over rocks and objects in the environment, Spawns 3 random types of hearts on the floor, *, pink, blonde, yellow, red, bow, baby mr dolly, Causes Isaac to spawn 6 troll bombs on the floor every time he gets hit, similar to the Anarchist Cookbook mechanic, Doesn't trigger on damage taken from blood donation machines and devil beggars (but still triggers on other forms of intentional self damage such as IV Bag), Item Pool: Item Room, Red Chest, Curse Room, Greed Mode Item Room, *, blue, orange, poster, torn, paper, page, ripped, A familiar baby that has a random chance to drop a battery pickup or freeze all enemies in the room for a short while, Charged Baby also has a chance to add one charge to your spacebar item, These effects can only occur while in a hostile room with enemies, Gives Isaac a +25% damage up for every tear that successfully hits an enemy, The bonus from Dead Eye maxes out at double your damage (+100%), If a tear misses an enemy, there is a chance for the multiplier to be reset back to 1. Based on the Steam Workshop mod created by Amethyst, UNLOCK: Unlock this item by using 5 Gulp! Placing a bomb this way will not affect your devil/angel room chances, Lil Dumpy follows Isaac and produces a Butter Bean fart when a projectile or enemy is about to hit Isaac, pushing the enemy back and preventing the damage, After it farts, it flies away, stops following Isaac and has to be picked up again before it will follow again, He also has a second larger detection radius that can randomly trigger from enemy projectiles, The effect only works if Lil Dumpy is following and near Isaac, You have a chance alongside each tear to shoot a red flame, which deals damage to enemies that come in contact with it, Damage starts at x4 your current tear damage, and scales down each time an enemy touches the fire, The chance to create a fire scales with your Luck stat, at +11 Luck you have a 50% chance to shoot one, The flames from this item can destroy shopkeepers, which is handy since doing this once per floor increases your devil/angel room chances slightly. in The Chest floor as The Forgotten, Item Pool: Item Room, Greed Mode item Room, When picked up, this item replaces all of your red heart containers with 6 Bone Hearts, Every time you lose a bone heart, lots of bones fire in all directions damaging any enemies hit and you gain a permanent +0.5 Tears Up, For the Lost and Keeper characters, this item simply gives a permanent Tears Up, UNLOCK: Unlock this item by defeating The Lamb in the Dark Room floor as The Forgotten, Obtained by beating the Basement 1 boss within 1 minute, then bombing the large shadow that appears in the middle of the starting room, While held, Mom's Foot will stomp on you from above twice every few seconds, and she will continue to stomp for as long as you hold this item, Using the Broken Shovel will stop Mom stomping you for the rest of the current room (or current wave if you're in the boss rush or challenge room), Beating the Boss Rush while holding this item will drop the second half of the Broken Shovel, which combine to create Mom's Shovel, which is used to unlock The Forgotten character, Dropping the Broken Shovel will cause it to disappear if you leave the room, NOTE: This item will not drop unless you have beaten The Lamb at least once, Added as part of the Afterbirth+ Booster Pack #5 and used in the quest to unlock The Forgotten character, Drops after beating the Boss Rush while holding the other half of the Broken Shovel (see previous item for more details), Combines with the first Broken Shovel piece to create Mom's Shovel (see next item for more details), When used, spawns a trapdoor that leads to the next floor, Unlocks The Forgotten character when used on a mound of dirt that appears in a room in The Dark Room floor, Obtained by combining the two Broken Shovel pieces. The Binding of Isaac: Afterbirth ID's I am a novice modder. This effect stacks with multiple shades, scaling the contact damage each time, UNLOCK: Unlock this item by defeating Delirium in The Void floor with Judas, Isaac gains a cloud familiar that follows him and leaves a trail of tears on the floor which damages enemies for 2 damage per tick, Enemies touching the cloud have a chance to activate the Crack the Sky effect, which spawns a light beam that deals damage equal to your tear damage + 20, Gives Isaac a small Hush familiar that bounces diagonally around the room dealing 2 contact damage per tick, While you're firing tears Hushy will stop moving, which allows you to keep it in one place, Hushy will block enemy tears and projectiles, UNLOCK: Unlock this item by beating Hush with Apollyon, Gives Isaac a small Monstro familar, who's tears can be charged and released in a shotgun style effect, much like Monstro's main attack, Lil Monstro's tears each deal base damage (3.5) and don't scale with damage upgrades, *, head, cleft, lip, palate, hairlip, tooth, A baby familiar that follows you and causes other familiars to follow it. While at full red health you also shoot a projectile across the room with each swing, dealing your current Damage + 2 (similar to the Master Sword in Zelda), UNLOCK: Unlock this item by defeating challenge #39 (Isaac's Awakening), While held, a red outline of a door will appear on certain walls. This may cause you to skip floors where you left a trinket to spawn a Cracked Key. Beyond the womb floor, replaces all coin and key spawns with a random pickup as follows: Bomb - 26.6% chance. ?, Satan and The Lamb as Tainted Eden, Each brand new room, this trinket has a chance to transform into a copy of a random passive item, which gives you the effect for the duration of this room, UNLOCK: Unlock this trinket by defeating Mother as Tainted Eden, Gives a small chance to spawn a friendly Bony when clearing a room, which will throw bones at enemies until it takes enough damage to die, Can be either the regular white Bony or the black variant, UNLOCK: Unlock this trinket by defeating Isaac, ?? satanic, star, red, black, Instead of tears, Isaac now shoots bombs from his eyes, which explode dealing damage to anything nearby, Bombs will also synergize with other bomb items and tear modifiers, including Sad Bombs, Mr. Mega and many more, REPENTANCE - Dr. Fetus bombs now scale with the player's tear size and are now immune to knockback from their own explosions. Mysterious Item ID's: 59, 235 and 263 There are 547 items in the game (AB+), according to the wiki, the in-game collection page and platinumgod. starting, bloody, white, bandages, lazarus rags, Gives Isaac a full mapping effect, revealing the entire floor and locations of all secret rooms, UNLOCK: Unlock this item by beating Satan with The Lost, * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, After the sword falls, extra items will no longer spawn, UNLOCK: Unlock this item by defeating The Lamb as Jacob & Esau, Upon use, spawns a giant puddle of lemonade that deals 8 damage per tick to any enemies which come in contact with it, Your tears are replaced with a sword which can be swung to deal damage (Damage * 3 + Base Damage). If you get hit while Cursed eye is a solid black colour you are guaranteed to be teleported to another random room on the floor. Sales can be randomly applied just like regular shops, The ladder disappears after leaving the starting room, even if you haven't used it yet, In Antibirth this was called Jacob's Ladder, which had to be renamed as Afterbirth+ already had an item with this name, UNLOCK: Unlock this item by defeating Isaac as Jacob & Esau, Permanently shows the location of the boss room on the map, After defeating the shown boss fight, this item will activate a use of the Sun card (full heal and map reveal), fully recharge your active item, remove curses from the floor, gives +3 Damage Up and +1 Luck up for the rest of the floor, Only available inside a Planetarium - a room that has a base 1% chance to appear, which increases by +20% every time you skip an Item Room (Must not enter to count as skipped), In The Void floor it shows a random boss room, which isn't necessarily Delirium's room, Adds one extra secret room and one extra super secret room to each floor. ?, Satan and The Lamb as Tainted Azazel, When entering a new room, gives a small chance to gain Azazel's short-range Brimstone laser for the current room and the ability to fly, UNLOCK: Unlock this trinket by defeating Mother as Tainted Azazel, Spawns 2 friendly Dips upon clearing a room, Dips that spawn after killing a Squirt turn friendly, UNLOCK: Unlock this trinket by defeating Isaac, ?? Will take red hearts first before any other, Eve starts with this item after donating 439 coins to the Greed Donation Machine, UNLOCK: Unlock this item by beating Satan with Eve, Item Pool: Item Room, Curse Room, Demon Beggar, * devil pool, devil room pool, devil deal, the lost item pool, starting, silver, grey, gray, Upon use, this item refreshes the current floor with brand new rooms, monsters and items, as if you had entered a new floor, UNLOCK: Unlock this item by beating Satan with Blue Baby, Item Pool: Item Room, Secret Room, Devil Room, Demon Beggar, * secret room pool, item room, treasure room, item room pool, pill, tablet, drug, white, Unlocked from the 'Once more with the feeling!' During this time he can walk over enemies to mark them for death. It returns after a room has been cleared, UNLOCK: Unlock this item by beating Greed Mode with Eden, Item Pool: Item Room, Secret Room, Greed Mode Shop, *, red, yellow, green, white, square, rectangle, When used, the D8 rerolls all of your stats, Will only effect your damage, tears, range and speed stats, Each stat is given a multiplier that applies after all other adjustments, UNLOCK: Unlock this item by beating Challenge #28 (Pride Day), * dice, pip, die, black, grey, gray, pyramid, triangle, Purity will boost one of Isaac's stats depending on the colour of the aura around him, When you take damage, the aura will be removed and replaced with another random one when you enter the next room, UNLOCK: Unlock this item by beating Blue Womb (Hush) with Maggy, Item Pool: Item Room, Angel Room, Greed Mode Item Room, Greed Mode Angel Room, Adds a chance for a black ring to spawn around killed enemies, dealing damage to others that touch it, The ring damage scales with your tear damage, The change for a ring to spawn scales with your lucky stat, UNLOCK: Unlock this item by beating Blue Womb (Hush) with Eve, Item Pool: Devil Room, Curse Room, Greed Mode Devil Room, *, grey, gray, silver, metal grabber, hand, robot, When Isaac has no red hearts, this item gives Isaac the ability to fly. * item room, treasure room, item room pool, green, cry, plant, Tears now shoot three at a time (Triple Shot). Use the arrow keys or WASD keys to move around. Every 40 seconds spent in the same room since last activating, when the timer displays 00, 20 or 40 seconds, a shield triggers, nullifying all types of damage for 10 seconds, As soon as Isaac has half a red heart or more, this item deactivates, UNLOCK: Unlock this item by beating Blue Womb (Hush) with Lazarus, While firing tears this item gives you 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 evil eye shots will be destroyed if they come into contact with enemies or obstacles, UNLOCK: Unlock this item by beating Greed Mode with Cain, Each time Isaac kills an enemy, you get a temporary +0.5 damage up which lasts for the current room, Each subsequent kill will stack further damage up to a maximum of +5 Damage Up after 10 kills, This item is the same principle as the Bloody Lust item from the original flash game, REPENTANCE - Added to the Devil Room pool, UNLOCK: Unlock this item by beating Greed Mode with Samson, Item Pool: Item Room, Devil Room, Greed Mode Item Room, After taking enough damage you will gain a permanent demon familiar, Possible familiars include: Dark Bum, Demon Baby, Leech, Lil' Brimstone, Succubus, Incubus, Lil Abaddon, Twisted Pair. Can only happen once per room, Visually this is almost identical to the Guardian Angel item, but without a face, UNLOCK: Unlock this item by beating Blue Womb (Hush) with The Lost, 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, Item Pool: Item Room, Greed Mode Item Room, Key Beggar. It also leaves a gas cloud at the place where it exploded, The bomb deals 185 damage + your tear damage on hit and leaves a damage over time poison effect that does 3 times your tear damage per tick, Synergizes with tear modifying items such as My Reflection or Tiny Planet, Has a chance to drop from the Sloth miniboss fight, Counts as 1 of 3 poison items needed towards the Bob transformation, REPENTANCE - The damage of this item was significantly boosted to 185 (from 50) in Repentance, and given the poison cloud effect. UNLOCK: Unlock this card by defeating Ultra Greedier mode as Tainted ??? the lost item pool, purple, cross, Item Pool: Curse Room, Devil Room, Demon Beggar, * curse room pool, devil pool, devil room pool, devil deal, red, 666, Item Pool: Devil Room, Curse Room, Demon Beggar, * curse room pool, devil pool, devil room pool, devil deal, piece of paper, bloody paper, contract, You can force spawn a cracked key by droping any trinket in a Boss Room or Item room, on any floor on your way down to Depths II. 3c pickups become 2c, Taking more than 1 steam sale reduces the price of all items even further, This item is called Steamy Sale on PS4, PS Vita, Xbox One and Switch versions, probably due to copyright reasons, Item Pool: Shop, Greed Miniboss, Shopkeeper, * shop room pool, shop item pool, red, pink, white, paper, Spawns 6 troll bombs at random locations around the room, Bombs are effected by other passive bomb items, Has a chance to drop from the Pride miniboss fight, Item Pool: Item Room, Library, Pride Miniboss, * Anarchist's Cookbook, Anarchists Cookbook library pool, library room, book room pool, item room, treasure room, item room pool, This shield stacks with Holy Mantle, giving you 2 free hits, Added as part of the Afterbirth+ Booster Pack #5. Tears are now white, do a lot more damage and move slower across the screen with a homing effect, * angel room pool, god room pool, angel room item, red, fire, flame, orange, cross, Does not increase your damage, simply makes your tears red, * boss room pool, boss room item, sticks, brown, yellow, * angel room pool, god room pool, angel room item, the lost item pool, cup, wooden, gold, It works great. Each room is locked to a specific trinket effect, meaning if you exit and re-enter a room, that specific room will always have the same effect. Cain - +1 Luck. Bombs, keys, cards, runes and batteries have a 20% chance, Can lead to game-breaking combinations with the D20 due to the amount of consumables and batteries spawned by the item sacks, REPENTANCE - Added to the Secret Room pool. UNLOCK: Unlock this item by getting all hard mode completion marks for the 17 non-tainted characters, Combine with Knife Piece 2 to create a Knife which can be fired across the room, dealing 25 damage to any enemies it comes into contact with, In the Downpour/Dross II, you will find a white flame somewhere, and a room with a mirror in it. Kicking a frozen enemy will push it into the wall, where it shatters and fires ice shards everywhere (these can then freeze other enemies), Isaac will now automatically charge up tears, allowing you to store them up and fire them rapidly for a short time, Any time you aren't firing tears, the charge bar will start filling up, for up to 3 seconds. The Rosary Bead changes this to a 75%/25% chance of an angel or devil room (respectively), When Isaac takes damage, there is a chance he will gain the Gamekid effect, turning him invincible and dealing contact damage to any enemies he touches, The chance to activate the invincibility effect is affected by your luck stat and at +38 Luck it will activate every time you get hit, * , the lost item pool, nes, game, grey, gray, Tears shrink and grow in size as they go across the room, Does not appear to affect your damage and only the hitbox size of tears, Tears now move in a wave fashion across the room, While held, tears move in a spiral pattern across the screen at high speed, Effectively increases your range due to the tear pattern, Tears become flat and disc shaped giving them a larger hitbox, While this trinket is held, all items in the Shop cost 0 coins, After buying any 0 cent item in the Shop, the trinket disappears, UNLOCK: Unlock this item by beating the Chest with Lazarus, *, grey, gray, dollar, bill, note, cash, money, Isaac no longer takes damage from walking over spikes and blood creep while this trinket is held, * , the lost item pool, brown, pink, lump, ball, spot, 33% chance to drop a coin for every rock that you destroy, REPENTANCE - Previously was 100%, now 33%, UNLOCK: Unlock this item by destroying 100 rocks, Mom's Leg will now appear every 20 seconds and stomp down randomly in the room dealing 300 damage to enemies. After reaching level 4 (and at a much lower chance before level 4), Bumbo will also continue to collect coins and drop random pickups, similar to the Bum Friend item, but can also drop pedestal items very rarely. See the Broken Shovel / Mom's Shovel items for more information on how to unlock, Rotten Hearts fill up a whole container the same as normal red hearts, or the rightmost heart if you're at full health, Every time you clear a room, you'll spawn 2 Blue Flies for each Rotten Heart you currently have, UNLOCK: Unlock this by entering the Corpse floor for the first time, Spawns 2-3 pills, black/bone hearts and/or bombs when picked up, Can spawn in place of a regular sack, including in Shops for 7c, Only one heart can spawn per sack as a maximum, UNLOCK: Unlock this by defeating Mega Satan as Tainted Judas, 48 Hour Energy - Fully recharges your active item and drops 1-2 battery pickups. 5c pickups become 3c. when entering the item room, Gives +1 Soul Heart when starting each new floor after picking this up, Currently this effect doesn't work in Greed Mode - It will show 2 items but the item rooms will have different items in them, Gives +0.4 Tears Up for each room completed without taking damage, up to a maximum of +2.0 Tears Up, When you take damage, the tears bonus is reset, Picking this item up counts and gives you a temporary +0.4 Tears Up as well, Allows you to double-tap the shoot button to create a holy shield for 1 second that pushes enemies back and deals 10 damage to them if they touch it, The shield also reflects enemy shots and beams back at them for some extra damage, Can only be activated every 3 seconds (Shown by a white glow and a ticking noise), UNLOCK: Unlock this item by defeating Hush as Bethany, At the beginning of each new floor, this item will stab Isaac and reduce your red health down as much as it can without killing you.