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FAQ/Strategy Guide by Lukethehedgehog

Version: 1.1 | Updated: 01/10/13

MMMMM?++++MM7  8MMMO++++++++++++++++++++7MMMMMMMD++++8MMMMZ+ 
MMMMM++++MM     MMMM$++++++++++++++++++NMM   MMMMM++++MMMMM+ 
MMMMM++++==ZNMMNNI==++MM=          M++++=MMMMMMMMM++++MMMMM? 

Table of Contents
Note: Use the Search Word command (Ctrl-F) to find a specific section.
 C1.1.......................Regular enemies
 C1.2.......................Bosses in the Basement
 C1.3.......................Bosses in the Cellar
 C1.4.......................Bosses in the Caves
 C1.5.......................Bosses in the Catacombs
 C1.6.......................Bosses in the Depths
 C1.7.......................Bosses in the Necropolis
 C1.8.......................Bosses in the Womb
 C1.9.......................Bosses in the Utero
 C1.10......................Bosses in the Sheol
 C1.11......................Bosses in the Cathedral
 C1.12......................Bosses in the Chest
 C1.13......................Bosses that appear anywhere
 C2.1.......................Activated Items
  C2.11.....................WotL Activated Items
 C2.2.......................Passive Items
  C2.21.....................WotL Passive Items
 C2.3.......................Trinkets (WotL)
 C2.4.......................Tarot Cards
  C2.41.....................Major Arcana
  C2.42.....................Minor Arcana (WotL)
  C2.51.....................WotL Pills
 C3.3.......................Room Contents
C4.0........................Final Words
 C4.1.......................Version History
 C4.2.......................Contact Info
 C4.4.......................Legal Stuff

C0.0 Introduction
 Hello! And welcome to my first guide. This will probably be my only, still. 
This guide will basically just cover the enemies, the items and the rooms. 
ALL the floors in The Binding of Isaac are randomized, except for all the 
2nd floor bosses starting with The Depths. Without further ado, let’s begin!
PS: Excuse my English if you find a grammar mistake, it’s not my native 
IMPORTANT NOTE: Whenever you read WotL, it means it’s exclusive to Wrath of 
the Lamb, the official expansion.
LESS IMPORTANT NOTE: When I say XXX, I actually mean ???

C1.0 Enemies
Otherwise known as monsters. You must defeat all of them in a room before 
continuing, although you can bomb your way out of them. This section will 
list all of them, along with their behavior.

C1.1 Regular enemies

Black fly
A black dot with wings
Harmless, can’t do touch damage, can be defeated on one shot, may turn into 
a Pooter.

Attack fly
A red flashing fly
Can do 1/2 heart with touch damage, it takes 2 tears to kill.

2 conjoined attack flies
Requires 3 tears to kill. Separates into 2 attack flies upon death, unless 
killed in one hit.

Eternal fly (WotL)
White fly
They circle corn poop or certain enemies, like the Hanger. They don’t change 
movement patterns until the poop or enemy is destroyed. Before that, they 
deal 1/2 heart damage and can’t be destroyed. After their host is destroyed 
they turn into large Attack flies. They are immune to the effects of 
Skatole. If they are circling around Poop you can leave the room and, when 
you come back, they will despawn.

Black fly with eyes and a thorax
It doesn’t deal touch damage and it doesn’t follow you. It launches blood 
balls which deal 1/2 Heart damage, it may appear from a black fly.

Fat fly
Similar to a Pooter, but with a bigger pink thorax
Same health and damage as a Pooter but launch blood balls on a V-pattern; it 
may spawn in place of a Pooter.

Boom fly
A big ball with legs, wings and a face
They explode on death, they don’t chase you actively, but bounce of wall and 
deal touch damage.

Red boom fly
Red boom fly with cheeks inflated
They release 6 projectiles on death, but don’t explode. The projectiles 
always have a set trajectory.

A black fly with a red body
They try to deal touch damage, they release 4 projectiles on a + pattern on 

Spit (WotL)
Sucker with a blue head and a green body
They charge towards you and release a green explosive projectile that deals 
1 Heart damage. They might even suicide to shoot the projectile.

Spider (WotL)
A red dot with legs
They run towards Isaac. They are unaffected by webs, and can walk between 
the corners of the rocks.

Big Spider (WotL)
A spider with a big black thorax
They have more Health than regular spiders. Like Moters, they spawn 2 
Spiders on death.

Trite (WotL)
An upside-down Isaac head with 4 eyes and legs
They leap towards Isaac. They can cover a lot by jumping, but they also wait 
a LOT (About 2 seconds) before leaping again.

It looks like... a boil
They start as a small sphere, but it begins growing. At full size, they 
throw blood balls. If hit, they’ll shrink, but grow back if they aren’t 

Gut (WotL)
A green boil
They throw green balls (Like Spits) at close range.

A white boil/gut
They spawn Spiders but don’t attack normally.

Walking Boil/Gut/Sack
They look like a Boil/Gut/Sack, but with legs
They attack just like their normal counterparts, but they walk. They also 
don’t regenerate health.

Crying people with a bloated head
They don’t attack, they run from the player (Even running into dangers to do 
so), and they don’t deal touch damage. They might explode and release blood 
on a + pattern, along with 2-4 random flies.

Mulligan with sewn eyes
They behave like Mulligans, but shoot blood on an X pattern and leave a 
troll bomb. If they explode on their own, they shoot 6 projectiles.

Mulliboom (WotL)
Mulligan with a bomb stuck on its head
They chase you and explodes on touch, dealing 1 Heart damage. They also 
explode when killed.

Mulligan without eyes, an open mouth and holes on its head
They act just like Mulligans/Mulligoons, except they don’t explode, and they 
cough up flies. When killed, they spawn 5 red flies.

Swarmer (WotL)
The decayed head of a Hive, surrounded by flies
They spawn regular flies, but will spawn a Pooter or a Fat fly upon being 
hit. When killed, they spawn a Boom fly. They are also immune to the touch 
damage quality of My Little Unicorn.

A headless body, always facing to the front (Similar to Isaac’s)
They jump around the room, and can jump over rocks or other obstacles. They 
follow Isaac only when he’s near them.

Flaming Hopper
A black Hopper with a flame where the head would be, unless it was a 
Champion, in which case it will be a darker shade of the original (Even the 
They spawn when they touch fire. They have more HP, double speed and leaping 
range and follow the player from longer.

A Hopper bleeding from the neck
They have a better sense of where is Isaac. They can leap high into the air 
and then launch blood on a + pattern.

A slightly fat body bleeding from the neck
They walk around blindly and don’t deal damage (Except touch damage).
They spawn when a Gaper or Mr. Maw is killed.

A Gaper with blood gushing out of his neck
They shoot blood balls.

A smiling Isaac crying blood
They try to touch Isaac via the most direct route. If there is no way to 
reach Isaac, it stands still until a path opens. They may turn into a Pacer 
or Gusher before dying.

Frowning Gaper
Like Gapers, but with their eyes closed. When they get close to Isaac, they 
open their eyes (They don’t have eyeballs).
They’re quicker than normal Pacers, and have a bigger chance of spawning a 
Pacer or Gusher.

Gurgle (WotL)
Green Frowning Gaper with eyes already open and a bent neck
They don’t turn into Pacers or Gushers on death, but they shoot green 
projectiles (Like Guts), but it’s somewhat inaccurate.

Mr. Maw
A Frowning Gaper with eyes open and a bigger mouth
When it’s near you, it launches its head (Still attached). If the body is 
killed first’ it turns into a Maw. If the head is killed first, they become 
a Pacer. If the neck is shot at AND destroyed, it becomes both.

A Frowning Pacer without a body
They shoot when they can hit you, and you can move them slightly with tears.

A Mr. Maw head
They behave like Horfs, but they can move towards Isaac.

Red Maw
A Maw with its mouth sewn
They can’t shoot, but they move faster and explode, throwing blood on a + 
pattern, when killed.

Psychic Maw (WotL)
A white Maw with its eyes and mouth stitched shut, and a third, flaming eye
Shoots homing blood. They have an Eternal fly.

A body make of muscles without eyes and a big, open mouth
They follow Isaac, and, when you kill them, they turn into a pile of goo, 
which must be destroyed before the Globin regenerates.

Gazing Globin
A Globin with eyes
It’s faster, does more damage, is stronger and runs away from the player 
when in goo form.

It looks like a shopkeeper from the front, but it has its brain exposed from 
It’s invincible from the front, but not from behind. It turns to Isaac when 
shot or if he’s near. You can use Cupid’s Arrow to damage him from the 

Selfless Knight
Like a Knight, but with a mouth wide open and Isaac’s face in the back of 
the skull
When they see Isaac, they will charge towards him.

Mask + Heart (WotL)
Like a Scream mask with a heart below it
The mask is invulnerable, but the heart isn’t. The hearts shoots on a + 
pattern when Isaac is near.

A piece of meat with eyes and a bone
It moves in random directions, shooting on a + pattern.

A black blob with yellow eyes, somewhat similar to Gish
It shoots on an X pattern.

I.Blob (WotL)
A white crying blob
It shoots in all eight directions

A maggot with eyes without pupils
They are blind and don’t follow you. They can’t shoot, either, but they deal 
touch damage.

A Maggot with black eyes and an open mouth
They move randomly until Isaac is within range, where they will charge 
towards him, until they reach a wall.

A Charger with its mouth closed
They move randomly and spit blood occasionally.

A brain
They move randomly leaving a trail of damaging blood.

A bigger brain
They don’t leave blood trails, but they jump and throw 8 blood balls. They 
turn into 2 Brains on death.

A ball of intestines
They stick to surfaces like rocks and walls, and stick to that path.

Mama Guts (WotL)
Similar to the Guts, but bigger
They behave just like the Mem-Brain, but with bigger HP. They split into 2 
Guts on death.

B. Licker (WotL)
A head with its tongue sticking out and chained to other B. Lickers
They are similar to Larry Jr. but when a one is destroyed, they ALL 

A worm with a big mouth
They move around until they spot you, where they will charge and deal 1 
Heart of touch damage. They may go underground and pop up anywhere, although 
they can’t pop up right under Isaac.

It resembles a smaller version of Scollex
They launch a green projectile. He can also jump out of the ground, dive 
back in, launch an X pattern blood shot and resurface anywhere.

A lump of muscles with a face
It pops out of the ground, shoots blood, and dives back in.

A parasite resembling a... leech
They behave EXACTLY like a Charger, only they are flying, thus, they won’t 
stop for rocks. They are also faster.

Kamikaze Leech
A black leech with an eye on its mouth
They explode on touch or death.

Holy Leech (WotL)
A white Kamikaze Leech
They are identical to a Kamikaze Leech, but they have an Eternal Fly around 

A skull filled with intestines
They are invulnerable when retreated, and never deal touch damage. They may 
rise up and shoot three blood balls.

Red Host
A Host with a red cranium
They can be damaged anytime, but they shoot more frequently and also shoot 5 

A fat headless body with an opening on its chest
It will move blindly around the room. When the player is in line, it will 
shake and launch a blood beam that travels over obstacles and lasts a few 

Double Vis (WotL)
A slightly paler Vis with a bloodstained chest and another opening on its 
It can shoot a beam from the back to.

Chubber (WotL)
A Vis with a small, green, mouth less head (The head looks like a worm)
It shoots a small worm that deals 1 Heart of damage instead of the blood 
beam. When destroyed, the worm must be destroyed too, or the doors won’t 

A brown spiked block
It moves on a horizontal or vertical line. It’s immune, to destroy it, you 
need to kill all other monsters (It can help you on this task: It damages 
any enemy it touches)

Slide (WotL)
A blue Poky
It’s stationary until Isaac lines up. They will begin charging, damaging any 
enemy it touches. It stops when it touches anything solid (Rocks, a wall, 
another Slide, etc). It’s not despawned even upon clearing a room.

A nerve-covered eye
Doesn’t move, it follows you with its view and shoots lasers when you stop.

Bloodstained Eye
A clean, white eye
They shoot the laser shot by Vis.

Isaac made of muscles
They mirror Isaac’s moves and tear shot exactly. The only way to defeat them 
is to outsmart it (For example, making it hit spikes, fire or another 
enemy), using a familiar, Mom’s Knife, invincibility items such as My Little 
Unicorn, or a bomb.

Evil Twin
A black, flying demon with 3 red eyes
It flies, so it can’t be killed by spikes, but its shots are slow, so it’s 
easier to damage them.

A fetus-like, hopping creature (Similar to Blastocyst)
They usually spawn in groups of 4, and have a health bar.

Floating baby ghosts with a bloody mouth
They float around shrieking and shooting. They can also teleport, usually 
near to Isaac.

Angelic Baby (WotL)
A winged Baby, without the bloodstained mouth
They shoot 3 blood balls instead of 3, and teleport more often, but they are 

Keeper (WotL)
A jumping head (The shopkeeper’s head, to be exact)
Being hit makes some of your coins get scattered, and one completely 
disappears. They also shoot on a V pattern. They can also jump over gaps, 
but not rocks or other obstacles.

Hanger (WotL)
A shopkeeper (Hanged and all)
It shoots 3 blood balls that steal coins (Like the Keeper). It floats.

Stone Grimace
A stone head
They shoot blood balls and are indestructible. Like Pokies, they die when 
every other enemy dies.

Vomit Grimace
A green Stone Grimace
They shoot a green bomb (Like the Spit).

C1.2 Bosses in the Basement

The Duke of Flies
A large, floating head filled with flies
Attacks: Coughs flies and large attack flies.

Champion forms:
Orange: Larger and spawns Suckers and normal Attack flies
Green: Shoots blood on all directions when he coughs, he also spawns Moters

A pair of conjoined twins (Of different size) united by an umbilical cord
Bigger brother: Charge at you, then stops to catch his breath.
Smaller brother: Shoots blood when united to the bigger brother. He gets 
enraged when you kill his big brother and begin to follow you. He can fly 
over rocks.

Champion forms:
Green: The smaller brother will be detached, but it will act as normal. They 
will also be slower
Blue: Slower, but with more HP

Larry Jr.
A large, segmented worm
Attacks: Pooping (LOL).

Champion forms:
Green: Lower HP, launches blood and doesn’t destroy poop
Blue: Slower, larger, more HP, and he doesn’t produce poop

A ball with a hare lip
Attacks: Hopping towards you, spitting blood, jumping and landing where the 
player was, launching blood upon landing.

Champion forms:
Red: Smaller and appears in pairs, except in levels like the Womb or Sheol, 
where there are three
Blue: Larger and has more HP. He can hop, but not jump

Steven (Unlockable by clearing the Basement 25 times, replaces Gemini)
A black Gemini, only Little Steven is directly connected to Big Steven, 
without an umbilical cord (Reference to another Edmund McMillen game, Time 
Fcuk [Sic])
Attacks: Same as Gemini, only Little Steven fires more aggressively, and 
when one dies, they explode and release blood balls.

C1.3 Bosses in the Cellar

A spider with an upside-down head
Attacks: Jumping around like Monstro twice as far, spawning Sacks, spawning 
spiders and generating white goo which slows you down.

Champion forms:
Pink: Smaller and faster. Drops Boils and Guts, and spawns Attack Flies
Black: Always drops black goo, which also slows you down, shoots projectiles 
and spawns Large Spiders

A worm
Attacks: Jumping out of the ground, dive at you and bury again, while 
shooting blood on an X pattern, jumping out of the ground and shooting a 
green explosive projectile.

Champion forms:
Black: More HP, shoots in all directions instead of the green projectile

The Blighted Ovum
It looks a bit like Gemini (In fact it IS Gemini after being killed for the 
first time), the Bigger Brother looks like a zombie, the Smaller Brother 
looks like a ghost
Zombie: Follows you without stopping to catch his breath, leaves a damaging 
blood trail.
Ghost: Stands still, shoots a blood beam when you go near. Can’t be damaged, 
but it dies when you kill the zombie.

Gurdy Jr.
A pile of guts, fat and other body parts and fluids. Gross. Art least she 
isn’t what she was originally going to (A pile of dead babies).
Attacks: Spawns Pooters, fires blood, charge at you incredibly fast.

Champion forms:
Blue: A smaller Gurdy Jr. appears in the room. They can only attack by 
Red: She can only spawn Fat Flies and charge. She has more HP and is bigger

C1.4 Bosses in the Caves

It looks like a broken moon rock to me
Attacks: It begins as one, but divides into 4 parts after being damaged 
(Similar to Envy). After a part is killed, it becomes a Charger.

Champion forms:
Violet: It divides into 3 instead of 4 parts; it’s slower and spawns a Boom 
Fly on death

Similar to Gurdy Jr.
Attacks: She goes into her body mass, and appears on a side. Then, she 
throws blood balls (Pretty annoying). She can also spawn flies, Pooters and 
Fat Flies. When she raises her arms, she summons 2 boils in front of her 
(More annoying).

Champion forms:
Sick-green: She doesn’t shoot blood, but she continuously spawns flies

A (very) fat man
Attacks: He jumps and tries to land on you, a-la Monstro. He hops and shoots 
pee balls in all 8 directions. Peeing on the floor. The pee puddles do 
damage, btw. Also, after 66% and 33% damage, he releases his eyes, which 
bounce of walls and can’t be destroyed.

Champion forms:
Blue: His eyes pop out right at the beginning
Yellow: He always leaves urine puddles, even when in mid-air

Similar to a Charger, but bigger
Attacks: Spawning Chargers, charging at you. Her charge deals 1 Heart of 

Champion forms:
Blue: Larger, slower and more resistant to knockback. She spawns Boils 
instead of Chargers
Orange: Smaller, faster, and spawns Spitties

C.H.A.D. (Unlockable by clearing the Caves 20 times, replaces Chub)
A red Chub (Reference to another Edmund McMillen game, Super Meat Boy)
Attacks: Same as Chub, but shrinks and becomes faster as you damage him, 
spawns Suckers instead of Chargers.

C1.5 Bosses in the Catacombs

The Carrion Queen
A skeletal worm with a fleshy spot at the back
Attacks: An alternate version of Chub, but she can’t spawn monsters. She can 
only be damaged by hitting her at the back, or feeding her bombs. She also 
spawns Red Poop which damages you on touch.

Champion forms:
Pink: Smaller and can’t move diagonally. She also spawns hearts which fire 
on an X pattern instead of Poop. Killing the hearts damages her.

The Husk
A posthumous version of The Duke of Flies, it looks like a skull
Attacks: Same as The Duke of Flies. It’s faster, spawns Spiders along with 
Flies, and it also fires Blood.

Champion forms:
Black: Spawns Boom Flies and periodically shoots blood in all directions. He 
leaves flies and 2 Boom Flies on death.
Pink: He never spawns enemies, but he shoots on all 8 directions constantly. 
He spawns Flies and 2 Red Boom Flies.

The Hollow
Guess what... another posthumous version. This time, it’s Larry Jr.
Attacks: Unlike Larry, The Hollow moves diagonally, and can fly above rocks. 
Other than that, he’s exactly like Larry Jr.

Champion forms:
Gold: Drop coins when you destroy a segment
Black: Spawns Boom Flies when you destroy a segment
Green: Shoots blood and, when a segment is destroyed, it spawns a Charger

The Wretched
Ding, ding, ding. Another posthumous version. Guess which one. Like Widow, 
only her mouth has been sewn shut, but another one has appeared on the 
Attacks: Like Widow, only she spawns a set of 2 Spiders, a Double Spider, or 
a Trite. Her puddle of white goo is larger, and she shoots white balls (Of 
that substance cobwebs are made of?) while she spews the goo.

C1.6 Bosses in the Depths

Monstro II
You’ll never guess...
Attacks: The blood cough has been replaced with a Shoop da Whoop-like lazor. 
Also, his jump has been altered: First jump, he shoots blood that deals 1 
Heart of damage. Second jump, he spawns 4 Suckers. These alternate.

Champion forms:
Red: Smaller and he only spawns 2 Suckers. He’s faster

A red imp
Attacks: He shoots on a + pattern, X pattern, the + pattern again. He also 
shoots on all 8 directions, and teleport. He’s also accompanied by a Poky. 
He can also spawn Boom Flies.

Gish (Unlockable by clearing the Depths 15 times, replaces Monstro II)
A black Monstro with yellow eyes and sharp fangs, one could say it resembles 
a Clot (Reference to another Edmund McMillen game, Gish)
Attacks: Instead of FIRIN MAH LAZOR! He shoots a black ball that leaves 
black goo which slows you down. He also spawns Clots and the first jump 
doesn’t shoot projectiles.

A foot, eyes, a hand or a lump of flesh (Depending on her current attack)
Attacks: It depends on the body part she’s currently showing:
Foot: She stomps you.
Hand: She slaps you when near any of the doors.
Eye: Nothing. Yes, nothing.
Flesh: She spawns enemies.
NOTE: Using The Bible is an INSTA-KILL. Don’t hesitate in using it unless 
you want a challenge.

C1.7 Bosses in the Necropolis

Mask of Infamy
A mask with a heart
Attacks: The Mask is invulnerable, the Heart isn’t. The Heart occasionally 
shoots blood on 8 directions. The Mask charges at you. After destroying the 
Heart, the Mask can take damage through the back. There isn’t a health bar.

Champion forms:
Black: The Heart fires homing shots on a + pattern.

Daddy Long Legs
A spider with 4 feet (It looks as if it were hanging)
Attacks: Stomping all 4 of his feet, stomping one at a time, coughing up 
Spiders, slamming his head and shooting blood in all 8 directions.

The Bloat
Posthumous version of Peep
Attacks: The same as before, but he begins without his eyes, piss being 
replaced with blood, and shooting blood from his eyeholes.

Champion forms:
Green: Launches 3 green balls after landing, spawns 2 Chargers after pissing 
blood, less HP.

Triachnid (Unlockable by clearing the Womb 15 times, replaces Daddy Long 
A grey DLL with one eye and 2 black fangs (Reference to another Edmund 
McMillen game, Triachnid)
Attacks: Same as DLL, only he has 3 feet, he leaves white goo and he spawns 

C1.8 Bosses in the Womb

Posthumous version of Pin
Attacks: The same as Pin, except he might poke out his head and launch 3 
green balls.

A fetus in amniotic liquid
Attacks First, he might either do a low hop and shoot blood on random 
directions, or a large jump which launches blood in all 8 directions. He 
divides in 2 upon taking enough damage. Then, he shoots blood in either an X 
or a + pattern after jumping and divides in 2 after taking enough damage (4 
Blastocysts). Then, he only fires in a + pattern after being still. He 
doesn’t shoot after jumping. Then, he divides in 2 Embryos (A maximum of 8 

Mom’s Heart
A heart
Attacks: Summon enemies and retract. Until 33%, when she doesn’t retract.

It Lives! (Unlockable by clearing the Womb 9 times, replaces Mom’s Heart)
A heart-body
Attacks: Same as Mom’s Heart, but it summons bosses.

C1.9 Bosses in the Utero

Posthumous version of Fistula, it looks as if it had teeth
Attacks: Same as Fistula, only she divides into 3 instead of 4 and spawns 
Spiders when the smallest part is destroyed.

Loki divided in 2
Attacks: Same as Loki, only they spawn Red Boom Flies.

C1.10 Bosses in the Sheol

I don’t need to describe it ¿Right?
Attacks: This is it. The final battle. There are 3 phases to it.
First phase: He summons the Fallen.
Second phase: 2 blood streams (First 5 then 4), shooting a blood laser from 
his mouth, and firing a blood beam from each hand. The latter two only 
happen when you are directly in front of him. If his eyes are open, he 
shoots from his hands. If they are closed, he fires from his mouth.
Third phase: He stomps like Mom.

C1.11 Bosses in the Cathedral

Attacks: Like Satan, there are 3 phases.
First phase: He’s in fetal position. He shoots 12 tears on a radial burst 
and retaliates with a stream of tears when hit.
Second phase: He stands up, crying. He shoots purple tears on all directions 
that home slightly and also retaliates.
Third phase: He grows angel wings and starts flying, smiling. Beams are shot 
from the ceiling, Angelic Babies will appear, and the same purple shots are 
shot in 6 directions. He no longer retaliates.

C1.12 Bosses in the Chest

Like the character XXX
Attacks: Same as Isaac. Yes, everything.

C1.13 Bosses that appear anywhere

The Fallen
A fallen angel
Attacks: Chasing you, firing blood beams on a + pattern, shooting 2 salvos 
of blood (First 3, then 4) at 50% health, he will divide in 2.

It looks a bit like a bat (He only appears in Devil Rooms)
Attacks:  Spitting the 2 salvos of blood, firing beams on a + pattern.

C1.14 Mini-Bosses

A floating fella with a troll face
Attacks: Touch damage, divides in 2 after taking enough damage, then those 
parts divide in 2 each (4 Envies), then, they divide in 2 each, this time 
with a ._. Poker face (8 Envies).

Super Envy (WotL)
A blue Envy
Attacks: Like Envy, but divides in 3, then 3 again (9 Super Envies), then 3 
again (27 Super Envies OMGWTFBBQ)

A Vis with a head
Attacks: Same beam as a Vis, also shoots on all 8 directions

Super Gluttony (WotL)
A Double Vis with Gluttony’s head, but vomiting blood
Attacks: Same as Gluttony but with another beam from the back, shooting 
blood similar to Monstro’s cough.

A shopkeeper that somehow avoided being hung (He appears in shops and Secret 
Attacks: 3 arrows from his mouth, spawning Hoppers. The blood or touch 
damage makes you lose 3 pennies: 2 are dropped and 1 disappears.

Super Greed (WotL)
Greed with a coin on each eyelid and a $ sign on his forehead
Attacks: Shooting 4 blood balls and spawning Keepers. He stills makes you 
lose pennies.

A pink Isaac under effect of the Virus (Many weals)
Attacks: Only touch damage. Don’t get me wrong, she doesn’t has any attacks 
other than touch damage, but she’s pretty darn fast, and won’t stop for 
anything except losing sight of you.

Super Lust (WotL)
Lust with a lot of punches and a bullet shot on her forehead
Attacks: Same as Lust, but she’s extremely fast and leaves a trail of blood 
that damages you.

A grey Isaac
Attacks: He can either put a Forever alone face, which means that he’s about 
to shoot beams (Not blood beams, they’re very thin) in an X pattern, or put 
a Troll face, which means that 6 Troll Bombs will spawn (He’s immune to 
them). It’s probably the easiest sin.

Super Pride (WotL)
Pride, but pink (I think it represents gay pride)
Attacks: Same as Pride, but the beams are in a + pattern, and 2 Mega Troll 
Bombs (which follow you) spawn instead of 6 Troll Bombs.

Ultra Pride (WotL)
Hard to describe, but it’s green and resembles Edmund McMillen with a 
familiar that resembles Florian Himsl
Attacks: 3 homing projectiles, a horizontal line of green goo that deals 
touch damage, and the familiar shoots one homing projectile.

Champion forms:
Green Florian: His attacks deal 1 heart of damage

A green Globin
Attacks: Spawning a Charger, shooting a green explosive ball.

Super Sloth (WotL)
A green Gazing Globin
Attacks: He can shoot 2 green balls and spawn 2 Spiders.

A man in a grey suit
Attacks: Shoot bombs, but he’s so stupid that he doesn’t run from the bombs 
even though they can damage him.

Super Wrath (WotL)
His suit is burned, he’s bigger, and he has a mouth
Attacks: He drops Mega Troll Bombs instead of normal bombs.

C1.15 Harbingers

Note: They are only unlocked when you defeat Mom for the first time.

Famine (The Basement)
An eyeless, starved man
First phase: He charges, goes through the wall, and comes from the other 
side, then spawn a Pooter or Fat Fly. If there are Flies on screen, he only 
charges every 10 seconds or when you align to his left or right.
Second phase: Only the head is left. He fires 3 blood balls.

Champion forms:
Blue: He shoots blood on 6 directions (Minus vertical), charges slightly 
diagonally, and then does a full circuit around the room. He can also shoot 
blood like Monstro in the Second phase. He can’t spawn flies.

Pestilence (The Caves)
A green corpse
First phase: Firing a green ball, leaving a green puddle and summoning 
Chargers and Spitties.
Second phase: he loses his head. He still leaves the goo and spawns red and 
black flies

Champion forms:
White: The First phase summons Trites and shoots white balls on 6 
directions. The goo turns with and just slows you down. The Second phase 
still fires the 6 balls and also summons Spiders.

War (The Depths)
A skinless man
First phase: He charges like Famine, but he does 3 runs, always coming 
slightly below his starting position (Unless he would be bellow the room 
when he comes back, then he would come back at the top, shooting on all 8 
directions, and dismounting, summoning 6 Troll Bombs, the mounting again.
Second phase: He loses his horse. He chases you like Lust and Gemini, and 
like the latter, he stops to catch his breath. Also, damaging him slows him 

Champion forms:
Black: He leaves a Troll Bomb when he charges, he dismounts less often, and 
summons 2 Mega Troll Bombs when he does. In the Second phase, he shoots in 6 
directions when he stops.

Death (The Womb)
An armless skeleton
First phase: He either summons 4 scythes that go around the room, or 2 that 
follow you. He can also use the Hourglass (See Items).
Second phase: He dismounts from his horse. The horse charges in a similar 
way to War, except he never stops. He can summon Knights and Selfless 
Knights. All of them, Death, the Knights, the Selfless Knights, and the 
horse, must be defeated.

Champion forms:
Black: Bigger, more HP, always summons 4 scythes and 2 Kamikaze Leeches 
instead of the Hourglass. Instead of Knights, he spawns Red Maws.

Conquest (WotL)
A light blue man with a blindfold
Attacks: It only has one phase. He shoots homing tears on a + pattern, he 
disappears and light beams appear on random locations, and he charges off-
screen, then summon several clones of himself.

Headless Horseman
A, I don’t know, ¿Headless Horseman?
Attacks: His head can charge across the room (Like War), shoot green bombs 
and leave green goo (Like Pestilence), Firing three shots at you (Like 
Famine), and summoning Knights (Like Death).

C2.0 Items

There are 5 types of Item:
Activated Items: They are stored on your Spacebar slot, and can be used once 
every a specific number of rooms, or instantly, like Kamikaze, but these 
ones usually have a cost, normally Heart damage. You can only hold one at a 
Passive Items: You can hold many at once, and they grant you a passive 
effect. There are 4 kinds, according to Ed 
 Weapon Items: these alter your tears in some way
 Stat Increasing Items: These increase your stats
 Passive Items: These ones alter other aspects, such as flight or accessing 
Secret Rooms anytime
 Familiars: These ones are divided into types as well:
  Spawners: These spawn a specific type of Pick-up
  Extra Lives: These ones give a specific amount of lives
  Shooters: These ones follow you around shooting alongside you
  Orbitals: These ones, instead of following you, orbit around you
  Unique familiars: There are only two: Cube of Meat and Guppy’s Hairball
Trinkets: They’re a combination between Activated and Passive Items: You can 
only hold one at a time (Two with Mom’s Purse), but they grant you a passive 
effect, usually changing some odds.
Tarot Cards: You can only hold one at a time and they use up your Q slot. 
They don’t have any difference from Activated Items, except being on another 
slot and thus being able to hold one of both.
Pills: They increase or decrease your stats, or use an attack such as the 
Bad Gas. Note that the first time you pick up one, you don’t know their 
effect until you use them, and that the color doesn’t identify a Pill in 
different playthroughs, but same color means same Pill in the same 

C2.1 Activated Items

Note: The effect given by Activated Items only works for the current room

Anarchist Cookbook
A white book with a red A
Spawns 6 Troll Bombs randomly
Can be dropped by Pride
3 Room Recharge (RR)

The Bean
A bean
Causes Isaac to fart, damaging and poisoning nearby enemies
Unlocked by destroying 50 Poop piles
1 RR

Bob’s Rotten Head
A green, rotting, eyeless head
Throws a bomb in the direction Isaac throws it, damaging and poisoning 
enemies, and destroying rocks, doors, and Secret Room doors 
Sloth and Pestilence are resistant to the poison
Found in Secret Rooms and as a drop from Sloth
3 RR

A brown book with a black cross
Turns Isaac into an angel, allowing him to fly
Mom, Mom’s Heart and It Lives Are instantly killed. Satan and Isaac 
instantly kill you, even after you kill them (Unless you have The Wafer)
6 RR

The Book of Belial
A grey book with an inverted pentagram
Doubles damage
It gives Isaac an angry face with empty eye sockets, blood coming from his 
eyeholes, and an inverted cross on its forehead
Unlocked by beating the game
Can be found on the Secret Room, Devil Room, and Library
Judas starts with it
3 RR

Book of Revelation
A purple book with a white cross
Adds 1 Soul Heart
Using it will make the boss of the floor a Harbinger, if possible (i.e. you 
haven’t already fought it)
May replace Stan with the Headless Horseman
Found in Shops, Devil Room, Library and Item Room
A rare drop by the Beggar
Unlocked by killing any Harbinger
6 RR

Book of Shadows
A beige book with a Triquetra on its front (A reference to the “Charmed” TV 
Grants invulnerability for 12 seconds
It surrounds Isaac with a bubble
Greed, Hangman and Keeper still make you lose coins
You can give Hearts to Blood Donation Machines and Devil Beggars without 
losing them, but you still pay for Items in the Devil Room
Found in the Library, Item Room, and Shop
3 RR

The Book of Sin
A black book with a bloody 7
Spawns a random Pickup, Pill, or Tarot Card
Unlocked by beating every Deadly Sin
Found in the Devil Room or Item Room
4 RR

Dead Sea Scrolls
A scroll
Uses a random Activated Item (Even a locked one)
If the Item used doesn’t have a recharge time (Like Kamikaze), it can be 
used again, and it can harm you if the used Item can do so

Deck of Cards
A card box
Gives Isaac a random Tarot Card
The card spawns in your inventory
6 RR

A red dice
Re-rolls all Activated and Passive Items on the current room
It can also change Shop Items or Boss Drops, except for specific drops, such 
as the Cube of Meat
Re-rolled Items are from the same pool as the drop, for example, using the 
D6 after fighting a Harbinger when there is an Item other than the Cube of 
Meat (Such as from a Beggar spawned with the Tarot Card XX The Judgment) 
will turn it into a Cube of Meat, or Activated Items can only be rerolled 
into other Activated Items, and the same for Passive Items
You can get locked Items with it
Unlocked by completing the Womb with XXX
Isaac starts with it after it’s unlocked
3 RR

Doctor’s Remote
A remote controller
It sets a big red target on the ground which can be controlled with the 
arrow keys. After some seconds, a missile comes crashing down
Pressing Space will cause the missile to appear prematurely
The missile acts like a huge bomb explosion
3 RR

Forget me Now
An aspirin
When you use it, you reappear at the starting room with newly generated 
Rooms, Monsters, and Items
It disappears after you use it
Unlocked by completing the Sheol with XXX
No room recharge, disappears after use

A Gameboy
Turns Isaac into a Pac-Man
It gives you invincibility, damages enemies on touch, enemies run away, and 
it heals 1/2 Hearts per 2 enemies killed
The health leech doesn’t work with XXX
You can give Hearts to Blood Donation Machines and Devil Beggars without 
losing them, but you still pay for Items in the Devil Room
Unlocked by visiting 10 Arcades
6 RR

The Hourglass
An Hourglass
Slows enemies and projectiles for 7.5 seconds
2 RR

A set of dynamite that Isaac wears strapped around its body
Causes an explosion around Isaac, causing 1 Heart of damage but damaging 
Affected by the Wafer
Tarot Cards that grant you invincibility allow you to use it without being 
0 RR, can be used immediately

Lemon Mishap
A lemon
Cause Isaac to pee, damaging enemies who touch it
Flying enemies aren’t affected
2 RR

Mom’s Bottle of Pills
A bottle of Pills
Spawns a random Pill
These appear on your inventory
Unlocked by using a Blood Donation Machine 20 times
6 RR

Mom’s Bra
A bra
Causes enemies to freeze for 5 seconds
It puts a bra on Isaac’s head
3 RR

Mom’s Pad
A menstrual pad
Enemies back away from Isaac for 5 seconds and don’t attack
3 RR

Monster Manual
A book with a drawing on its front
Summons a random familiar (Even locked ones)
Summoning a Cube of Meat will summon it in a random level
Unlocked by completing the Sheol with Judas
4 RR

Monstro’s Tooth
A bloody tooth
Monstro jumps on a random enemy
It can’t be used on Monstro, but it can be used on Monstro II
Unlocked by beating all the bosses in the basement
3 RR

Mr. Boom
A bomb with a smile
It drops a large bomb
It has an increased range (3 squares)
2 RR

My Little Unicorn
A unicorn horn
Gives Isaac temporary invincibility and damages enemies on touch
You can’t fire unless you have Mom’s Knife
Greed, Super Greed, Hangman and Keeper still make you lose coins
You can give Hearts to Blood Donation Machines and Devil Beggars without 
losing them, but you still pay for Items in the Devil Room
6 RR

The Nail
A bloody nail
Turns Isaac body into a black demon with twisted horns, adds one Soul Heart, 
and breaks rocks when you walk over them
Increases damage by one and decreases speed by 2
Unlocked by completing the game 3 times
Can be found in the Devil Room, the Curse Room, given by a Devil Beggar or 
as a possible drop from the Fallen
6 RR

The Necronomicon
A brown book with a face
Damages all enemies in a room significantly
Unlocked by using the Death Tarot Card 4 times
It destroys all enemy shots too
6 RR

A Pony
A black horse head
It mounts Isaac on the Headless Horseman’s horse
While equipped, it increases Speed by 2 and grants flight
When used, Isaac will charge in the selected direction
Can be obtained from the Headless Horseman
If you press Spacebar but you don’t touch a directional key, you will become 
invincible and damage enemies on touch
Greed, Super Greed, Hangman and Keeper still make you lose coins
You can give Hearts to Blood Donation Machines and Devil Beggars without 
losing them, but you still pay for Items in the Devil Room
4 RR

The Poop
A pile of Poop
It drops a pile of Poop, like the ones in the Basement
It may give a coin, like regular Poop
Unlocked by clearing the game 10 times
XXX starts with this item
1 RR

Razor Blade
A Gillette
Deals a certain self-damage, but strengthens you for the current room
Removes your skin, making you look like a Dople
It removes Heart Containers before removing your Soul Hearts
Unlocked by completing the Womb with Eve
0 RR

The Pinking Shears
A pair of shears
Separates Isaac’s body from his head
The head can fly
The body acts like a familiar (Essentially a powered up Meat Boy)
Unlocked by dying 100 times (Ouch)
Found in Shops and Item Rooms
6 RR

Shoop Da Whoop!
The iconic face
FIRIN’ MAH LAZOR! From Isaac’s mouth
Turns Isaac’s face into a Shoop da Whoop
It’s fired in the chosen direction and doesn’t stop until it reaches the 
Sometimes dropped by Envy
3 RR

Tammy’s head
A yellow cat head
Shoots 10 tears in a circle around you
Modifiers, such as Spoon Bender or My Reflection, alter these tears, but not 
Brimstone, Technology, or Dr. Fetus
More commonly found in chests
1 RR

A blue remote
Teleports you to a random room
2 RR

We Need To Go Deeper
A shovel
Creates a trapdoor to the next level
You can’t use it to skip the second floor in “No damage” achievements, but 
you can skip the first one
Found in the Item Room or the Devil Room, or as a possible drop from the 
Cannot be used to skip from the Cathedral to the Chest
6 RR

Yum Heart
A heart with a bite
Restores one whole heart
Unlocked by having 7 heart containers on one playthrough
Useless with XXX
Magdalene starts with this Item
4 RR

C2.11 WotL Activated Items

Best Friend
A pink doll
Deploys a decoy Isaac that eventually explodes
Can hurt Isaac
Can be eaten by Chub
Familiars will be transferred to the decoy
3 RR

Blood Rights
A butterfly knife
Consumes HP to damage all enemies in the room
Unlocked by beating Sheol as Samson
Makes blood pour from the walls
0 RR

The Candle
A blue candle
Throws a blue flame that damages anything in its path
Unlocked by completing Challenge 1
Recharges in about 3 seconds
It can damage Mom by firing at the doors and It Lives by firing at where he 
should be even when they are retracted
Evaporates enemy shots
Often found in shops
0 RR

Crack The Sky
A feather
Makes beams of light bombard random areas, dealing massive damage
The pattern is random
4 RR

Crystal Ball
A crystal ball with an Isaac face
Reveals the map and gives a random Tarot Card or Soul Heart
Found in a Fortune Telling Machine

A 20 sided dice
Randomly changes all PICKUPS (Hearts, Coins, Bombs, Troll Bombs, Tarot 
Cards, Pills, Trinkets, and Chests, even opened ones)
Doesn’t reroll Items
Found in the Item Room
Unlocked by beating the Cathedral with Isaac
6 RR

Dad’s Key
Opens every normal door in a room when used
Unlocked by beating the Chest
Found in the Secret Room and Item Room
2 RR

Guppy’s Head
A black and white cat head
Spawns 2-4 Blue Flies
Found in the Devil Room, Red Chests, Challenge Rooms, or as a drop from the 
Collecting Guppy’s Head, Tail and Paw transforms Isaac into Guppy, giving 
him flight and The Mulligan effect
You only need to use these Items once, you can drop them afterwards
1 RR

Guppy’s Paw
A paw
Removes one Heart Container in exchange for 3 Soul Hearts
Does nothing for XXX
Found in Curse Rooms, Devil Rooms or as a Boss Drop
0 RR

IV Bag
A blood bag with a syringe connected to it
Exchanges Hearts for Coins (Basically a portable Blood Donation Machine)
Works well with Bloody Penny
Reward from a Blood Donation Machine, and, as such, has the same 
vulnerability of the BDM: You can spam it if you have invincibility, such as 
using The Book of Shadows and immediately picking up the Bag
0 RR

Notched Axe
A Minecraft pickaxe
Breaks a single rock, poop pile, or fire when used
1 RR

Prayer Card
A card with an image of Mary
Grants half an Eternal Heart when used
Completing an Eternal Heart, or going down a floor will turn it into a Heart 
Found in Item Room, Angel Room and Shop
6 RR

Portable Slot
A Slot Machine
It acts like a Portable Slot Machine
Costs one coin to use
Found in the Item Room, Shop, Golden Chests and Devil Rooms
0 RR

Remote Detonator
A dynamite detonator with “Boom” inscribed in it
Detonates all bombs you place
Bombs only detonate when you use this
Gives 5 bombs
0 RR

Spider Butt
A spider thorax
Damages all enemies and inflicts slowdown
Found in the Item Room
Unlocked by completing Challenge 8
2 RR

Telepathy for Dummies
A “for Dummies” book
Gives Spoon Bender effect
Found in the Library and Item Room
2 RR

White Pony
A white horse head
Same as the A Pony item, but with the added effect of Crack The Sky
Found after defeating Conquest
6 RR

C2.2 Passive Items

A heart
A pulsing heart is attached to Isaac’s chin
Sometimes dropped by gluttony, can be found in the Item Room

A green mushroom
If you die, Isaac will respawn in the previous room with full health
Can be picked up multiple times in a single playthrough
Only appears in Secret Rooms

9 Volt
A battery
Jams a battery into Isaac’s head
Leaves Isaac with 2 bars already charged after using an item
Fully charges your Activated Item upon Pickup
Most common in Shops

A battery
Gives Isaac Frankenstein bolts
Gives Isaac an extra charge every 15 seconds up to 3charges
Using an Item a second will reset the charge

The Belt
A belt
Gives Isaac a belt
Found in the Boss Room or the Item Room

Blood Bag
A blood bag
Stains Isaac’s face with blood
Increases HP by one, Speed by 1 and heals 4 hearts
Can be won an picked up multiple times
Obtained when a Blood Donation Machine explodes from overuse

Blood of the Martyr
A thorn crown
Gives Isaac a floating thorn crown
Increases damage by 2
Turns tears into Blood

A bomb with a face and a crank
Gives 5 bombs and causes all bombs to slide towards enemies
It applies to Dr. Fetus and Wrath bombs, too

Bomb bag
A bag with bomb image
Isaac is followed by a small bag that drops either a Bomb, a 1+1 Free Bomb 
or a Troll Bomb

A bomb with an X10 next to it
Puts a lit fuse on Isaac’s head
Gives Isaac 10 bombs
Found in the Item Room and Challenge Room

A box of milk
Increases HP by one
Found in the Boss Room or as a Drop from the Beggar

An arcane symbol, it looks like an Infinite symbol with a cross on top
Makes Isaac black and gives him horns (Buffalo horns)
Changes tears to a chargeable laser that pierces everything
The laser must be charged for 2 seconds
Increasing your Tear stat reduces charge time
Removes knockback effect
Available on the Devil Room, as a drop from the Fallen, or from a Devil 

Brother Bobby
A blue ghost
Fires normal tears
Found in the Item Room, Devil Room, from Devil Beggars, or as a drop from 
the Fallen

Bucket of Lard
A bucket of lard
Makes Isaac fatter
Gives 2 empty Heart Containers, heals half a Heart, reduces Speed by 1
Rarely dropped by Gluttony, can be found on the Item Room

Charm of the Vampire
A bat
Gives Isaac a Dracula-like appearance
Killing 13 monsters heal you by 1/2 a Heart
Flies do not count, but splitting the Fallen, Envy, or Fistula will
Globins turning into Goo count too
Useless to XXX

Chocolate Milk
A glass of chocolate milk
Cheeks inflate (Only while charging shots)
Removes rapid-fire
Allows you to charge tears

The Common Cold
A snot
Isaac’s face turns green
Turns tears green
Gives a chance to poison enemies
Unlocked by finding two of either Roid Rage, The Virus, or Growth Hormones

The Compass
A compass
Shows the Icons of Special Rooms
Does not reveal Secret Rooms or Top Secret Rooms
Found in Shops, Challenge Rooms, or from the Beggar
It’s never on the Item Room

A Cube of Meat
A cube of meat
It can stack depending on how much you picked
1 CoM: The Cube follows you like a Pretty Fly
2 CoM: It turns into a head. It acts like the Cube, but it now fires blood
3 CoM: It turns into a humanoid Meat Boy, this time he chases enemies but no 
longer shoots. Also, note that he can shove Pickups while walking, including 
bombs, so be careful
4 CoM: Bigger size and damage

Cupid’s Arrow
An arrow
Isaac wears a native-American headdress
Isaac tears can pierce enemies (Even Knights, allowing you to damage them 
from the front)
Shots don’t pierce obstacles

Dead Bird
A black bird
Isaac wears it on his head (Familiar)
When taking damage, the bird comes to life and begins attacking
Unlocked by making 2 deals with the Devil
Eve starts with this item

A Guppy
Found in the Devil Room and Red Chests
Your HP is set to 1, but you’re given 9 lives
After each death, your HP is set back to 1

A bag of dog food
Adds 1 Heart Container
Found in the Boss Room

A can of dog food
Adds 1 Heart Container
Found in the Boss Room

Distant Admiration
A fly with 2 waves surrounding it
A fly further than Halo of Flies, but closer than Forever Alone

Demon baby
A black baby with horns
Fires blood at enemies in range
Unlocked by completing the Sheol with Eve

A Dollar
A dollar
Sets your pennies to 99
A final reward from the Slot Machine, they appear when you use it to much it 
explodes (It doesn’t always happen, though)

Dr. Fetus
A fetus in a jar
Gives Isaac the monocle and top hat of Dr. Fetus, from Super Meat Boy
Replaces Isaac tears with bombs
Increases chance of Bomb-related Items
Unlocked by completing the game 5 times
A rare find in the Item Room

Forever Alone
Similar to Distant Admiration, but with the waves reversed
It orbits far away from Isaac

Guardian Angel
A baby with wings
All other Orbits orbit at double speed
Unlocked by completing the Sheol with Magdalene
Found in the Item Room and God Room

Growth Hormones
A purple syringe
Isaac receives inhuman growths
Increases Speed and Damage by 2

The Halo
A halo
Gives Isaac a halo
Increases all stats except range by 1
Unlocked by defeating any Mom boss with the Bible
Found in the Item Room and God Room

Halo of Flies
2 flies
They block projectiles that touch them and kill other flies

The Inner Eye
An eye
Gives Isaac a third eye
Sets firing rate to minimum, but it gives a triple shot

The Ladder
A ladder
Allows gaps to be crossed when they are only 1 block wide
Fairly common in Shops

Little C.H.A.D.
A smaller version of C.H.A.D.
Drops 1/2 Heart for completion of every 2 rooms
Useless for XXX
Unlocked by killing C.H.A.D.

Little Chubby
A smaller version of Chub
Charges towards the direction Isaac’s firing
Unlocked by defeating all the bosses in the Caves

Little Gish
A smaller version of Gish
Follows Isaac shooting tar balls
The tar slows down enemies
Unlocked by killing Gish
Dropped by Gish

Little Steve
A smaller version of Steven
Follows Isaac shooting homing projectiles
Unlocked by killing Steven
Dropped by Steven, or in the Item Room

Loki’s Horns
A pair of horns
Gives Isaac horns
Gives a random chance to fire in a + pattern
The chance is increased with your Tears stat
If you have The Inner Eye and Mom’s Eye, the shot is always fired
Unlocked by defeating all the bosses in the Depths

Lord of the Pit
An inverted cross
Makes Isaac black and gives him wings
Grants flight
Can be found in the Devil Room or as a drop from the Fallen

Lucky Foot
A foot with a chain
Gives Isaac a golden anklet on his left leg
All pills will have positive effects
Increases chance of getting pickups from poop and fire
Increases chance of winning the Skull Game
Increases chance of getting Items from Gold Chests
Increases chance of getting Items from the Fortune Telling Machine
Cain starts with this Item
Found in the Item Room, Devil Room, and Boss Room
Unlocked by collecting 55 pennies in one playthrough

A bowl of dog food
Increases HP by 1

A Lump of Coal
A Lump of Coal
Stains Isaac’s face with coal dust
Increases damage based on how further tears travel
Found after fighting Krampus

Magic Mushroom
A red mushroom (Reference to Mario Bros)
Isaac grows
Fully heals Isaac and increases all his stats by 1
Will give XXX 1 Soul Heart

A magnet
Isaac gets a magnet on his head
Attracts all pickups (Including Troll Bombs) from about 7-8 squares
Hearts, Soul Hearts and Eternal Hearts aren’t attracted at full health

The mark
A triangle of 6
Gives Isaac the Mark on his forehead
Increases Damage by 2 and Speed by 1
Adds 1 Soul Heart
A drop from the Fallen or found in the Devil Room or Red Chests

Max’s Head
A puppy’s head
Isaac’s eye grow bigger and shinier
Increases Damage by 1
Tears are bigger and inflict more knockback

Mini Mushroom
A blue mushroom (Again, reference to Mario Bros)
Increases Speed and Range by 1
Shrinks Isaac’s hitbox

Mom’s Contact
A red eye
Isaac’s right eye turns red
Gives Isaac a petrifying shot
Unlocked by collecting Mom’s Eye and any other Mom Item

Mom’s Eye
A white eye
Isaac gains an eye on the back of his head
Increases Tears Stat
The eye allows you to shoot from behind at random
The other eye always fires the default tears, so Technology or other similar 
Items don’t affect it

Mom’s Heels
A heeled shoe
Isaac wears heeled shoes
Increases Range by 2
Mainly found in the Boss Room

Mom’s Knife
A knife
Isaac wears a dress and holds the knife
Isaac only shoots the knife, boomerang-style
Overrides all attacks
Pierces enemies
It can be used like a Melee Weapon
You can use it with My Little Unicorn
Unlocked by beating the Sheol with Isaac

Mom’s Lipstick
A lipstick
Isaac uses lipstick
Increases Range by 1
Mainly found in the Boss Room

Mom’s Underwear
A woman’s underwear
Isaac wears it (LOL)
Increases Range by 1
Found in the Item Room and Boss Room

A $ symbol
Gives Isaac $-$ glasses
Increases Damage based on how many coins Isaac has (10 coins=+1 Damage)
Found in the Item Room and Devil Room
Unlocked by completing the game 8 times

Mr. Mega
A bomb with a face, the eyes are similar to Wrath
Gives Isaac Wrath’s helmet, along with the twitching
Gives Isaac 5 bombs
All bombs are like Mr. Boom
This also applies to Dr. Fetus bombs
Unlocked by using 10 bombs
Found in the Item Room and Shop

My Reflection
A broken mirror
Gives Isaac a Sailor Moon symbol on his forehead
Isaac tears boomerang back to him
Range is set to minimum
Bad with Ipecac

Number One
A yellow drop
Isaac stops crying. His tears turn yellow and come from his lower part 
Sets firing rate to maximum but range to minimum

Odd Mushroom (Thin)
A mushroom with a small cap
Isaac’s head shrinks
Increases Speed by 1, sets Rate of Fire to maximum and reduces damage by 1
Found in the Item Room and Shop

Odd mushroom (Large)
A mushroom with a small cap
Grows Isaac’s head
Increases Damage and HP by 1, reduces Speed by 1
Found in the Item Room and Shop

Ouija Board
An Ouija board
Gives Isaac a spectral face
Tears (Spectral Tears) go through obstacles but not enemies (Effectively the 
opposite of Cupid’s Arrow)
Available in the Devil Room, Item Room, or from Beggars

The Pact
A Bloody Sheet
Makes Isaac black with horns and a more aggressive face
Increases Damage by 1 and RoF (Rate of Fire) by 2
You gain 2 Soul Hearts
Can be dropped by the Fallen or in the Item Room

The Parasite
A slug
A slug appears on Isaac’s head
Makes the Tears split in 2 when they hit something
Sets RoF to 1
Unlocked by collecting 2 dead things (Guppy, Bob’s Rotten Head, Max’s Head, 
Tammy’s Head) in a single playthrough

A pentagram
Horns appear on Isaac’s head
Increases Damage by 2
Increased chance of finding a Devil Room
Found in the Boss Room

A medical degree
Isaac wears a Surgical Mask
All Pills become good or neutral
Reveals names on 5 seconds of pickup
Increases coins dropped from Blood Donation machines from 1-3 to 2-4

A quarter
A silver coin with a 25 on it
Gives 25 coins
Sometimes found in the Item Room or Devil room
Sometimes dropped by Greed
Unlocked by beating the game 4 times

Raw Liver
A liver
Increases HP by 2 and fully heals you
Reduces Range by 1
Primarily found in Secret Rooms or as a drop from Gluttony

The Relic
A cross
It drops a Soul Heart upon completion of 4 rooms
Unlocked by completing the Womb with Magdalene

A robotic baby
It shoots a Technology laser
Unlocked by completing the Womb with Judas

Roid Rage
A green syringe
Increases Speed and Range significantly
Found in Challenge Rooms, Item Rooms and Shops

A rosary
Isaac wears it
Gives you 3 Soul Hearts
Increases chance for a Bible to appear
Found in the Item Room and Shop
Increases HP by 1

Rotten Meat
Gives you 1 Heart Container
Found in the Boss Room and in Gold Chests

Sack of Pennies
A sack with a cent symbol
Drops a coin upon completion of 2 rooms
Unlocked by completing the Womb with Cain

The San Onion
A crying onion
Isaac cries harder
Doubles RoF
More commonly found in Chests

Sister Maggy
A red Brother Bobby
Shoots blood, which does more damage

A fly with a heart
Puts a pile of poop on Isaac’s head
All flies turn passive and no longer attack
Boom Flies are slowed
Rewarded by the Shell Game

Skeleton Key
A key with a skull
Isaac gets a keyhole on his forehead
Gives you 99 keys
Found in the Item Room and Challenge Room

Small Rock
A rock
Isaac gets a rock jammed on his skull
Increases Damage by 2 Tears by 1 and decreases Speed by 1
Found in X Rocks
Unlocked by bombing 50 rocks

Spelunker Hat
A miner hat
Isaac wears the hat
Shows the location of Secret Rooms, Top Secret Rooms, and shows if  room is 
a Sacrifice Room or Mini-Boss Room
Unlocked by completing the Caves

Spider Bite
A spider
Gives Isaac a bite on his head
Tears have a chance to slow enemies
Only found in the Secret Room
Unlocked by completing the Basement

Spoon Bender
A bended spoon
Gives Isaac a third eye
Tears turn purple and homing

Steam Sale
A price tag
Isaac has a price tag on his head
Reduces costs of all things found in a Shop (See Rooms for a list of prices 
with and without sales)
Can be dropped by Greed or a Beggar and can be found in Shops

Steven’s head
Isaac gets a growth similar to Steven’s
Increases Damage by 2
Dropped by Steven
Can be found in golden chests

Super Bandage
A Bandage
Isaac has a bandage in his head and a flower (Similar to Bandage Girl from 
Super Meat Boy)
Increases HP by 1 and gives 2 Soul Hearts
Rarely found in the Boss Room
Unlocked by defeating 4 Harbingers in a Boss Room

A cyborg eye
Gives Isaac the eye on his left eye
Shoots a laser that pierces enemies

A noose
Isaac becomes a floating head
Gives flight
Only found in Secret Rooms
Found after completing the game twice

Treasure Map
A map
Shows the layout of the floor, including the Secret Room but not the rooms 
Common in Shops and commonly found in Challenge Rooms
Occasionally dropped by Beggars

The Virus
A red syringe
Isaac looks like lust, but paler
Isaac deals touch damage and can poison enemies
Enemies still deal touch damage
Sometimes dropped by Lust, or found in Challenge Rooms

The Wafer
A wafer
Isaac gets a blue aura around his head
Reduces all damage to half a Heart, or rounded to the nearest Half Heart
Unlocked by completing the game 7 times

Whore of Babylon
A moon with a star
Isaac becomes a black demon with horns and an inverted cross on his forehead 
(Only with active effect)
When reduced to half a Heart, a message pops ups saying “What a horrible 
night to have a curse…” (Reference to Castlevania 2: Simon’s Quest) and you 
turn into the Whore of Babylon, with Damage and Speed multiplied
Found in the Devil Room, Item Room, Shop, or as a drop from the Fallen
Eve starts with this Item

Wiggle Worm
A worm
Isaac eyes begin shaking
Isaac’s tears wave
Tear Speed is increased by 1
Tears don’t angle with movement
Found in the Shop and Item Room

Wire Coat Hanger
A hanger
The hanger goes through Isaac’s Head
Increases Tears by 2

Wooden Spoon
A spoon
Isaac gets spoon marks all over his head
Increases Speed by 2
Found in the Boss Room and Gold Chests

X-Ray Vision
X-Ray glasses
Isaac wears X-Ray glasses
Reveals and opens Secret Room entrances

C2.21 WotL Passive Items

3 Dollar Bill
A purple bill with a 3
Isaac becomes happy and stars appear when he fires
Gives you a variable effect:
Mom’s Contact
My Reflection
Number One
Ouija Board
Spoon Bender
The Inner Eye
Tough Love
Magneto (Bug)

A doll head
Fires in the opposite direction at you
Unlocked by completing the Cathedral with Cain

An Ankh
Isaac wears the Ankh along with some eye shadow
When killed, you respawn in the last room as XXX

The Black Bean
A black bean
Isaac appears fatter
When you take damage, Isaac farts

Bloody Lust
A blood drop
Isaac wears a red bandana
Increases damage for each enemy killed
Samson starts with this Item

Bob’s Curse
A green bomb with a face and an empty eye
Isaac’s face becomes green and misses an eye
Bombs turn into Bob’s Rotten Head without a fuse
Gives 5 bombs and grants all bombs a poison effect

A box
Isaac wears a box around his body
Spawns 1 coin, 1 key, 1 bomb, 1 heart, 1 card, 1 pill and 1 trinket
Decreases Speed by 1
A drop from bosses

Bum Friend
A beggar
It just acts as a portable beggar
He can pick up coins by itself
Pushes your bombs

A whip
Isaac gets cuts all over his face
Tears travel faster
Found in the Boss Room

Celtic Cross
A cross with a circle behind
A Celtic cross circle appears behind Isaac’s head
30% chance to give Isaac a shield upon taking damage
Unlocked by completing the Cathedral with Magdalene

Chemical Peel
A bottle of Acid
Isaac’s left side of his face is peeled, revealing muscle
Tears fired from the left eye do increased damage
Doesn’t work with Mutant Spider
Cain randomly fires tears with increased damage

Daddy Longlegs
A ball of yarn
Daddy Long Legs follows you and stomps on enemies

Dead Dove
A dove
Isaac becomes a “ghost” with the same face as Ouija Board
Gives Isaac flight and Spectral Tears
Found in the Item Room, God Room and Library (?)

Epic Fetus
Same as Dr. Fetus, but the jar has a top hat and the fetus is angry and 
raising his middle finger
Isaac looks just like he would do with Dr. Fetus but with an angry eyebrow
Tears become guided missiles (Like Doctor’s Remote)
Unlocked by completing Challenge 6

XXX’s head
Isaac gets angelic wings
Isaac gains flight and an Eternal Heart
Rarely found in Golden Chests

Ghost Baby
A ghostly baby
It fires spectral tears

Guppy’s Hair Ball
A hair ball
Loosely follows behind Isaac
Can be swung by moving rapidly in a circle
When an enemy is killed it increases in size
The bigger it is, the easier it is to swing, the larger it’s collision 
circle becomes, and the more damage it does
Unlocked by transforming into Guppy
Found in the Item Room

Guppy’s Tail
A tail
Isaac wears the tail around his waist
Increases chance of Chests appearing
Decreases chance of pickups appearing
Found in the Challenge Room, Devil Room and Red Chests

A habit
Isaac wears it
When hit, it recharges some of the Activated Item you currently have
Doesn’t work when you are invincible

Harlequin Baby
A red baby with red eyes
Shoots 2 blood balls diagonally
Found in the Item Room

Holy Grail
A golden cup
Isaac gets wings and an angelic halo
Adds 1 empty Heart Container and grants flight

Holy Water
A vial of holy water
When Isaac takes damage, the vial breaks, leaving a damaging puddle similar 
to Lemon Mishap

A worm
Isaac becomes fatter and green, with several boils
1-3 Blue Flies spawn every time Isaac gets hit

A medicine bottle
Isaac’s face gets green, and he looks sick
He spits projectiles similar to Sloth’s
The balls can poison enemies

Jesus Juice
A carton of juice
Isaac has juice stains around his mouth
Increases Damage, despite the text saying otherwise

Magic 8 Ball
An 8 ball
Isaac wears the headdress of a fortune teller
Increases Tear Speed
Spawns 1 Tarot Card when collected

A piece of meat
Isaac looks angry with a bulging vein
+1 HP and Tears
Also, it increases damage (Though unlisted)

A Mitre (Which is, the headwear of the Pope)
Isaac has a holy halo
Greatly increases the chance of spawning Soul Hearts
Stacks with Mom’s Pearl

Mom’s Purse
A purple purse
Isaac holds the purse
Allows you to hold 2 trinkets
Commonly found in Shops

Mom’s Coin Purse
A coin purse
Isaac hangs it from his neck
Spawns some random Pills
Found in Shops and the Boss Room

The Mulligan
A blue fly with a blue heart
Isaac gets several fly bites around his head
Chance to spawn blue flies when attacking enemies

Mutant Spider
A green spider
Isaac gets 4 eyes and 2 fangs
Hoots 4 tears at once
Reduces RoF
Overrides the Inner Eye

Pageant Boy
A pink crown
Isaac wears it
Spawns several coins around Isaac
Chance to spawn coins on being damaged
Found in the Boss Room
Increases the chance of getting coins from Slot Machines

The Peeper
An eye
Isaac loses his left eye, which begins acting like Peep’s eye
The eye acts like Peeps, as it bounces around the room
Tears fired from the left eye do increased damage

A shining eye
Isaac becomes a Cyclops
Isaac shoots one huge tear
If the tear kills an enemy, it continues going with the remaining power

A smiling bomb with an X99 next to it
Isaac gets four lit fuses on his head
Adds 99 bombs
Can rarely be found in the Secret Room

Rainbow Baby
A pink baby with a rainbow
Shoots a random type of tear (V Shots, Bloody Tears, Slowing Shots, etc)
Unlocked by completing the Cathedral as XXX

Sacred Heart
A flaming heart with a cross
Isaac’s eye glow white and tears glow too
Shots are larger, slower, and homing
Gives 1 Soul Heart and heals 1 Full Heart
Damage is multiplied
Decreases Tears by 1
Found in God Room, Curse Room and from Devil Beggars

Sacrificial Dagger
A bloody dagger
Does very high damage
Unlocked by completing the Cathedral as Eve

Two pieces of cloth united by bands
Isaac has a yellow aura around his head
When reduced to 1/2 Heart, the aura disappears and Isaac gets a Soul heart
When XXX takes a hit that would normally finish him, he immediately gets 1 
Soul Heart

SMB Super Fan!
A bloody buzz saw
Isaac looks like Meat Boy, with red skin, a black eye, a chipped tooth, and 
leaving blood wherever he goes
Increases all Stats except Speed by 1
Decreases Speed by 1
Unlocked by completing Challenge 7

Speed Ball
A white syringe
Isaac’s eye dilate
Increases Speed of both Isaac and his Tears

Spirit of the Night
A moon similar to that of the Whore of Babylon
Isaac becomes a black ghost, with white eyes and a weird mouth
Grants flight and Spectral Tears (Effectively a demonic Dead Dove)
Found in the Devil Room

A squeezer
Isaac’s eyes pop out
+1 Tears
Spawns 2 Soul hearts

Stem Cells
A stem cell (I think so)
A fetus grows on Isaac’s head
Grants 1 Soul Container
Heals 1/2 Heart

A cross
Isaac cries blood, along with some bloody spots on his forehead
Increases Damage by 1
Grants 1 Heart Container
Found in the Item Room

Technology 2
A cyborg eye, not unlike Technology
Isaac gets a cyborg eye on his right eye
Fires a continuous piercing laser while shooting normal tears from the left 
Cain, having a patch on his left eye, can only fire the laser

Some toothpicks
Eyes are held up with toothpicks
Increases Tears
Decreases Range by 1
Tears go faster

Tough Love
Some brass knuckles
Isaac is all beaten up
Isaac randomly shoots teeth that do triple damage and can break the limit
The chance of shooting teeth depends on your luck stat, and at the highest 
luck Isaac always shoots teeth
Found in the Item Room

C2.3 Trinkets (WotL)

XXX’s Soul
A doll looking like XXX
Gives you a familiar that moves around the room shooting spectral tears
Some familiars might follow this new familiar instead of you
Unlocked by completing the Chest with XXX

Ace of Spades
An ace of spades
Increases chance of finding Cards

Bloody Penny
A bloody penny
Unlocked by completing the Cathedral with Samson
Gives a 50% chance of getting 1/2 Heart when collecting a penny

Burnt Penny
A burnt penny
Unlocked by completing Challenge 3
Gives a 50% chance of getting a bomb when collecting a penny

Cain’s Eye
An eye
Unlocked by completing the Chest with Cain
Gives 25% of activating the Compass effect when starting a floor

A tumor
Doubles Tears stat

Child’s Heart
A heart
Increases the chance of receiving Hearts from drops

Counterfeit Penny
A golden penny
Unlocked by completing Challenge 9
Gives a 50% chance of getting an additional coin when picking up coins
Can be found in Golden Poop

Cursed Skull
A skull
If Isaac’s health is brought down to 1/2 Heart, he teleports to the last 
room completed as well as teleporting XXX every time he’s damaged
If you teleport when fighting a boss, you will have to fight it again at 
full health
PROTIP: Don’t pick it up

Curved Horn
A horn
Unlocked by completing the Cathedral with Judas
Increases Damage

Eve’s Bird Foot
A bird foot
Gives a chance of spawning a Dead Bird
Unlocked by completing the Chest with Eve

Flat Penny
A flat penny
Gives a 50% chance of spawning a key when picking up a coin

Fish Head
Unlocked by completing Challenge 5
Attack flies spawn every time you get hit

Goat hoof
A hoof
Increases Speed

Isaac’s Head
Isaac’s head
Unlocked by completing the Chest with Isaac
Gives Isaac’s head as a familiar
It shoots Piercing Shots

Isaac’s Fork
A fork
Clearing rooms has a 10% chance of being healed 1/2 Heart

Judas’ Tongue
A tongue
Unlocked by completing the Chest with Judas
Items in the Devil Room only cost 1 Heart (or 3 Soul Hearts)

The Left Hand
Unlocked by Ultra Pride, also dropped by defeating him
Replaces all Chests with Red Chests

Liberty Cap
A mushroom
25% chance of giving one of the mushroom effects when entering a room

Lucky Toe
A toe
Unlocked by completing Challenge 2
Increases chance to get a drop upon clearing a room

Maggy’s Faith
Unlocked by completing the Chest with Magdalene
Gives an Eternal Heart at the start of every floor
PROTIP: Not really useful unless you have loads of Soul Hearts or can avoid 
getting hit very well

Match Stick
A match
Increases chance of getting bombs from drops

A Missing Page
A page
5% chance of using The Necronomicon effect upon taking damage

Mom’s Pearl
A pearl
Increases chance of turning a Red Heart pickup into a Soul Heart before 
The effect stacks with Mitre

Pinky Eye
A red eye
10% chance to fire a poisonous tear

The Polaroid
A photo of Isaac’s family before it broke (at least, it looks like the 
father died, or they divorced, but I’m not going to start theories)
Unlocked by completing the Cathedral six times
If Isaac’s health is reduced to 1/2, or XXX takes damage, he gains a shield 
like the Book of Shadows
If holding it while opening the Chest after defeating Isaac, you will 
continue into the Chest
Always dropped by Mom (If it’s unlocked)

Push Pin
A pin
10% chance to fire a spectral and piercing shot

Red Patch
A patch
When hit, Isaac randomly gains an effect similar to Razor Blade

Rusted Key
A brown key
Improves the chance of Keys and Golden Chests dropping after clearing a room

Safety Cap
A cap
Improves drop rate of Pills

Samson’s Lock
A lock
Unlocked by completing the Chest with Samson
Random chance increasing damage when killing an enemy

The Tick
A tick
Isaac gets a tick jammed into his head
Bosses spawn with less health, and you get healed a full Heart
Can’t be replaced with another trinket

Umbilical Cord
An umbilical cord
When you drop to 1/2 Heart, Little Steve appears

C2.4 Tarot Cards

There are 2 types of Tarot Cards, but they play the same:
Major Arcana: Introduced in the original game
Minor Arcana: Introduced in WotL

C2.41 Major Arcana

0 The Fool
Teleports you to the starting room, even if already in it

I The Magician
Same as Spoon Bender

II The High Priestess
Mom’s foot stomps on a random enemy
Will stomp Isaac if used when there are no enemies

III The Empress
Same as Whore of Babylon, except you can use it anytime

IV The Emperor
Teleports you to the Boss Room
If used in the Boss Room, the fight will restart

V The Hierophant
Spawns 2 Soul Hearts

VI The Lovers
Spawns 2 Regular Hearts

VII The Chariot
Same as My Little Unicorn

VIII Justice
Spawns 1 random type of Heart, Bomb, Key and Coin

IX The Hermit
Teleports you to the Shop
Acts as a random teleport if used in the Shop

X Wheel of Fortune
Spawns a Slot Machine or Fortune Telling Machine

XI Strength
One time use of Magic Mushroom

XII The Hanged Man
One time use of Transcendence

XIII Death
Same as Necronomicon

XIV The Tower
Same effect as Anarchist Cookbook

XV The Devil
Same effect as Book of Belial

XVI Temperance
Spawns a Blood Donation Machine

XVII The Stars
Teleports you to the Treasure Room
Randomly chooses one with Curse of the Labyrinth
Acts as a random teleport when there is none, or if you are in it

XVIII The Moon
Teleports you to the Secret Room

XIX The Sun
Completely heals you, damages all enemies, and shows the entire map

XX Judgment
Spawns a Beggar or Devil Beggar

XXI The World
Reveals the entire map

C2.42 Minor Arcana (WotL)

The Joker
Transports you to the Devil Room
You exit to the starting room

2 of Hearts
Doubles your current Hearts

2 of Spades
Doubles your Keys

2 of Clubs
Doubles your Bombs

2 of Diamonds
Doubles your Coins

C2.5 Pills

Note that the color of the Pills doesn’t indicate its effect

Possible Colors:
All blue
All orange
Red and red-spotted
Blue and white
All white
Red and white

Possible effects:

Bad Gas
Isaac farts

Bad Trip
Isaac loses 1 Heart
If at 1 Heart or less, you are healed

Balls of Steel
Gives you 2 Soul hearts

Bombs are Key
Swaps the amount of Keys and Bombs you currently have

Explosive Diarrhea
Drops lit Bombs as you walk

Full Health
Restores Health up to maximum
Will heal XXX to 3 Soul hearts if at less

Health Down
Decreases HP by 1
Same effect from Bad Trip applies

Health Up
Gives an empty Heart Container
Tins Isaac red

I Found Pills
Gives Isaac a dumb face

Pretty Fly
Gives a fly that circles you, like Halo of Flies

Range Down
Decreases Range by 1

Range Up
Increases Range by 1
Tints Isaac blue

Speed Down
Decreases Range by 1

Speed Up
Increases Range by1
Tints Isaac Yellow

Tears Down
Decreases Tears by 1

Tears Up
Increases Tears by 1
Tints Isaac purple

Single use of Teleport

C2.51 WotL Pills

Possible colors:
Blue and cyan
Yellow and orange
White and orange-spotted

Possible effects:

Luck Down
Decreases your Luck

Luck Up
Increases your Luck
Tints Isaac Green

Friends Till The End!
Gives you 3 blue flies

Isaac grows pubic hairs on his head

C3.0 Miscellaneous

C3.1 Characters

Every character (except for XXX) resembles a Dungeons and Dragons character 
class, which was also confirmed by Edmund in his Formspring 

Health: How much Heart Containers the character starts with
Speed: How fast is the character at the start
Tears: How fast the character fires (Not how fast the tear goes, but the 
delay between each shot)
Attack: the damage each Tear does
Range: How much they reach before falling
Hidden Stats:
Luck: Increases chance of Pickups appearing
Shot Speed: How fast the tear goes

The Fighter (Because of his higher health and average stats)
Unlocked at the beginning
Starting Items: D6 (When unlocked), X1 Bomb
Health: 3
Speed: 2
Tears: 2
Attack: 2
Range: 2

The Cleric (Due to her higher health and health “regeneration”, which is the 
Yum Heart)
Unlocked by: Having 7 Heart Containers at the same time
Starting Items: Yum Heart
Health: 4
Speed: 1
Tears: 2
Attack: 2
Range: 2

The Thief (Because of his higher speed and lower HP, along with a key)
Unlocked by: Having 55 pennies at the same time
Starting Items: Lucky Foot, X1 Key
Health: 2
Speed: 3
Tears: 2
Attack: 3
Range: 1

The Wizard (Due to his low HP)
Unlocked by: Defeating Mom’s Heart
Starting Items: Book of Belial, X3 Pennies
Health: 1
Speed: 2
Tears: 2
Attack: 4
Range: 2

The Druid (Not really sure why)
Unlocked by: Making 2 deals with the Devil in one playthrough
Starting Items: Whore of Babylon, Dead Bird
Health: 2
Speed: 3
Tears: 2
Attack: 1
Range: 2

The Blue Baby
Unlocked by: Defeating It Lives 
Starting Items: The Poop, X3 Soul Hearts 
Health: 0
Speed: 2
Tears: 2
Attack: 2
Range: 2

Samson (WotL)
The Berserker (He can deal more damage the more enemies he kills)
Unlocked by: Skipping 2 Item Rooms (You can enter, but you can’t pick up the 
Item) and defeating Mom
Starting Items: Bloody Lust, X1 Soul hearts
Health: 1
Speed: 2
Tears: 2
Attack: 2
Range: 2

C3.2 Rooms

Common Room
The most common one, might contain enemies, and a Pickup might most likely 
spawn in the center

Item Room
Contains an Item
Marked with a Crown
Items that don’t appear here:
Some Boss Drops
Some Devil Room offerings
Items that appear in other places, such as Small Rock or Blood Bag

Secret Room
Unmarked in the map, but can be found by bombing a specific wall
Might contain Coins, an Item, a Slot Machine, a Fortune Telling Machine, or 

Marked with a coin
Might contain any of the following at the following prices (Numbers in 
brackets are when in sale)
Regular Heart: 3 [2]
Any other Pickup: 5 [3]
Item: 15 [7]
Items that usually appear here:
9 Volt
Steam Sale
Book of Revelations
Treasure Map
Notched Pickaxe
Mom’s Purse
Mom’s Coin Purse

Boss Room
Indicated by an unique door and a skull on the map
Contains a Boss (duh)
Contains an Item after defeating the Boss

All of the above always appear in the first 3 chapters

Curse Room (WotL)
Marked by a spiky door that, when you walk in and out, you get 1/2 Heart of 
Contains a Red chest

Sacrifice Room (WotL)
Unmarked at first, marked with blood after entering it
It contains a spike tile, which, when passing over it enough times, will 
reward a chest
The spikes do 1 Heart of damage

Super Secret Room (WotL)
Only adjacent to 1 room, or, sometimes, the Secret Room
Kinds of SSR:
Sheol: 2 Red Chests
Cathedral: 1 Eternal Heart
Womb or Utero: 7 or 8 Full Hearts
Cellar: 1 Trinket
Necropolis: A Fortune Telling Machine
Library: Random Tarot Card

Challenge Room
Marked with a sword and a unique door, locked with bars and 2 crossed swords 
above it
You must be at full health to enter it, or enough Soul Hearts to make it up 
(For example, you have 4 Heart Containers, but only 2 are full. But, if you 
have 2 Soul hearts, you may enter)
XXX can always access these
Contains a Chest or Item
Upon picking it up, you must fight 3 waves of enemies

Marked by a die
Must give a penny to enter
The door has a neon sign saying “Arcade”
Inside, there are 3 games (I’ll go into details on them later, on the Room 
Contents section C3.3):
Slot Machine/Fortune Telling Machine
Skull Game
Blood Donation Machine

Mini-Boss Room
Unmarked initially, after entering, marked by a smaller skull
Contains a Deadly Sin, Super Deadly Sin, or Ultra Pride

Boss Challenge Room (WotL)
Marked with a bloody sword on the map
The door is similar to that of the Challenge Room, but with a skull over the 
You must fight two bosses, one after the other, except for the Depths, where 
you fight both at the same time
You must have 1 Heart or less to enter, ignoring Soul Hearts
XXX can always enter these

Library (WotL)
Marked with a book
Door identical to the Shop
Contains 2 book Activated Items
Has a higher chance to appear when you are holding a book as your Activated 
Possible books:
Anarchist Cookbook
Book of Belial
Book of Revelations
Book of Shadows
Book of Sin
Monster Manual
Telepathy for Dummies

All of the above might appear but not always

Inaccessible normally
To access it, you must Teleport, there’s a 1% chance you’ll end up here
In it, you’ll find a Shopkeeper with the hairstyle of Edmund McMillen that’s 
glitching, along with the floor
There’s a trapdoor leading to the next floor
You can’t access the Cathedral from this room
You will also find any of the following
A free Item and 9 Pills
A free Item and 4 Chests
A free Item, 13 Coins and 3 priced things
2 free Items
2 priced Items and 5 coins

Devil Room
Has a chance to appear after defeating the Boss
The door has the stone head of Satan
You can trade Heart Containers (Either 1 or 2) or 3 Soul Hearts for Items
In the Womb, it contains a trapdoor to Sheol
Possible offerings:
Stigmata: 1
The Mark: 1 or 2
The Pact: 2
Guppy: 2
Lord of the Pit: 2
Sister Maggy: 1
Brother Bobby: 1
Technology: 1
Lucky Foot: 1
The Nail: 2
We Need To Go Deeper: 1
Book of Sin: 1
Book of Belial: 1
Book of Shadows: 1
The Common Cold: 1
The Necronomicon: 1 or 2
A Quarter: 1
Money = Power: 1
Yum Heart: 1
Brimstone: 1 or 2
Parasite: 1
Ouija Board: 1
Whore of Babylon: 1 or 2
Razor: 1
Demon Baby: 2
Mom’s Knife: 1
Forget Me Now: 1
Monster Manual: 1
Doctor’s Remote: 1
Odd Mushroom (Thin): 1 HP
WotL offerings:
Guppy’s Head: 1 or 2
Guppy’s Paw: 1
Spirit of the Night: 2
Bloody Lust: 2
Tough Love: 1
Guppy’s Tail: 1 or 2
Sacrificial Dagger: 1
D20: 1
Ways to increase the chance of it appearing:
Have 1 Pentagram
Have another Pentagram
Have Book of Revelations
Have Book of Belial
Killed a Beggar
Took no Red Heart damage
Took no Red Heart damage on the Boss

God Room (WotL)
Similar to a Devil Room, but it only contains 1 Item at no cost
The door is marked with a cross on top of it and light coming out of the 
Possible offerings:
Blood of the Martyr
Guardian Angel
Dead Dove
Holy Grail
Prayer Card
The Relic
Sacred Heart
Ways to increase the chance:
Not making deals with the Devil
Using the Bible (Unconfirmed)
Picking up items saying “Faith Up” (Rosary, Guardian Angel)
Giving money/Hearts to Beggars
Using Blood Donation Machines (Unconfirmed)
Having an offering from a previous God Room

C3.3 Room Contents

These are the things that you might encounter on a room, either hindering 
you or helping you, depending on their position and your current Items

Cobwebs (WotL): Slow you down, can be destroyed with a Bomb

Pits: Can only be crossed with flight or the Ladder, or by destroying a rock 
next to it to plug it

Spikes: Damage when you touch them, can be crossed with flight or 

Rocks: Block you, can be destroyed with a Bomb, or can be used to plug a 
pit, or flown over

Black Rocks: Can’t be destroyed

X Rocks: Blue rocks with an X, contains some Pickups, indistinguishable from 
other tocks in the Womb

Keystone: Block your path, can be opened with a Key

Fire: Damages you if you touch it, even if you fly
Enemies are vulnerable to it to, except for Hoppers, which turn into F. 
Can be extinguished, and may drop a Pickup

Hellfire (WotL): Same as the regular fire, only red, and it can *puts on 
sunglasses* fire back YEAHHHHHHHHHHHHHHHHH!!
Nah, seriously, these ones fire blood at you randomly, so you should always 
extinguish it

Poop: Can be destroyed, might drop a Coin or Heart

Red Poop (WotL): This kind is generated by The Carrion Queen or in some 
areas in the chest
It can’t be permanently destroyed; it can regenerate, usually when standing 
on it

Corn Poop (WotL): Has corn in it and an Eternal Fly circling it 

Golden Poop (WotL): More durable, might drop Coins or the Counterfeit Penny

Slot Machine: Bump into it to use a coin and give a chance of getting an 
1 Penny
2 Pennies
1 Heart
1/2 Heart
2 Hearts
1 Key
Black Fly
1 Soul Heart
1 Bomb
1+1 Free Bomb
Pretty Fly
1 Pill
Troll Bomb
Mega Troll Bomb
Explosion (Same as if you bombed it)
1 Nickel
1 Nickel and 1 Penny
1 Eternal Heart
A Dollar (The machine explodes)

Skull Game: Bumping into the Dealer gives him 1 coin, and then he will put 
either a Coin, Heart, Bomb, Key or Skatole under a skull, and then he will 
mix the skull
The base chance is 33%, 50% with Lucky Foot
If you want a Pickup, bomb the dealer and he will immediately give the 
Pickup he put under the skull (Doesn’t work with Skatole)
Failing spawns a red fly
Getting Skatole causes the Dealer to leave

Blood Donation Machine: Bumping into it will give 1/2 Heart to the machine, 
returning 1-3 Coins
After using it too much, it might explode, giving either the Blood Bag or IV 
Can be blown up to get some Hearts and Coins
Order of priority: Eternal Hearts, Red Hearts, Soul Hearts
PROTIP: Don’t use it if you have an Eternal Heart

Fortune Telling Machine (WotL): Bumping into it might give any kind of Item 
or Pickup, a fortune or nothing at all
After overuse, it explodes, giving the Crystal Ball

Beggar: Bump into him to give him a Coin
If you give him enough Coins, he might give an Item, Trinket or Pickup
Getting an Item will cause it to leave. Can be blown up to get some random 
Pickups but not Items
Giving him 5 Coins will ensure he gives you an Item if he hasn’t gave you 
anything before

Devil Beggar (WotL): Similar to a Beggar, but bumping into him will give him 
1/2 Heart
They might sometimes give a Devil Room Item
When blown up, they spawn 2 Spiders
Their priority is the same as Blood Donation Machines

Chest: Doesn’t need a Key to open
Possible contents:
A smaller Chest that can be normal or golden

Golden Chest: Requires a Key to open
Possible contents:
The same as a regular chest
An Item
Items more commonly found in a Golden Chest:
Sad Onion
Tammy’s Head
Rotten Meat

Red Chest (WotL): Found in Curse Rooms or Challenge Rooms (More commonly)
Possible contents:
2 Troll Bombs
1 Mega Troll Bombs
Soul hearts
A Devil Room Item
2 Spiders
3 Blue Flies (Friendly)

C3.4 Pickups

Half-Heart: Fills an empty Heart Container by 1/2

Full Heart: Fills a whole Heart Container

Soul Heart: Gives a temporary, non-refillable Heart Container

Eternal Heart: Only exist in half, getting 2 or completing the floor turns 
it into a Heart Container

Key: Used to open locked chests, doors or Keystones

Golden Key: Can be used without wasting the key count only for the current 

Penny: Gives you 1 Coin

Nickel: Gives you 5 Coins

Dime (WotL): Gives you 10 Coins

Bomb: Can be deployed and explode, damaging enemies and destroying rocks and 

1+1 Free: Gives you 2 Bombs

Troll Bomb: Acts like a lit bomb, but doesn’t damage certain enemies, like 

Mega Troll Bomb: acts like a Troll Bomb but follows you around

C3.5 Challenges

These can be accessed from the main menu.
This is how they are unlocked:
1-4: At the start
5-9: After defeating Mom
10: After defeating Isaac

Challenge 1: Dark was the Night: Gives you the Curse of the Darkness for the 
entire playthrough
Ends by defeating Mom
Unlocks the Candle

Challenge 2: 7 Years Bad Luck: gives you minimum luck
You start without any Activated Item
Ends by defeating Mom
Unlocks the Lucky Toe

Challenge 3: Large Marge: Gives you Curse of the Labyrinth for the entire 
Ends by defeating Mom
Unlocks the Burnt Penny

Challenge 4: 9 Deaths: Gives you the Guppy Item
Ends by defeating Mom
Unlocks Guppy Tail

Challenge 5: Lord of the Flies: Gives you Infestation and the Mulligan
No Item Rooms
Ends by defeating Mom’s Heart
Unlocks the Fish Head

Challenge 6: The Doctor’s Revenge: Gives you the Dr. Fetus and Doctor’s 
No Item Rooms
Ends by defeating Mom’s Heart
Unlocks the Epic Fetus

Challenge 7: Meat 4 Evar: Gives you a Level 4 Meat Boy
No Item Rooms
Ends by defeating Mom’s Heart
Unlocks the SMB Super Fan

Challenge 8: Spider Boy: Gibes you the Mutant Spider and Spider’s Bite
No Item Rooms
Ends by defeating Mom’s Heart
Unlocks the Spider Butt

Challenge 9: Isaac Was Good Today: Gives you the Holy Grail and the Halo
No Item Rooms
Ends by defeating Satan
Unlocks the Counterfeit Penny

Challenge 10: The Purist: You start with the D6
No Item Rooms
Ends by defeating Isaac
Unlocks the Daddy Longlegs

C3.6 Unlockables

NOTE: Most achievements unlock when you either unlock something or unlock 
with regular story progression. As such, I won’t list them. Just note that 
the only achievements that aren’t unlock able or story related are the ones 
that require you to get 100% and to clear a floor without getting hit

There are 5 types of unlockable:
A new Item
A new Character
A new Boss
A new Chapter
An increase in difficulty

Boss Rewards:  
Spider’s Bite: Complete the Basement
Spelunker Hat: Complete the Caves
A Cube of Meat: Complete the Depths
Halo: Defeat Mom or Mom’s Heart using the Bible
Monstro’s Tooth: Defeat all bosses in the Basement
Little Chubby: Defeat all bosses in the Caves
Loki’s Horns: Defeat all bosses in the Depths
The Book of Revelations: Defeat any Harbinger
Little Steve: Defeat Steven
Little C.H.A.D: Defeat C.H.A.D. 
Little Gish: Defeat Gish
A Lump of Coal: Defeat Krampus
Harbingers: Defeat Mom
The Womb: defeat Mom

Ending Rewards:
Book of Belial: Defeat Mom’s Heart for the first time
Transcendence: Defeat Mom’s Heart for the second time
The Nail: Defeat Mom’s Heart for the third time
A Quarter: Defeat Mom’s Heart for the fourth time
Dr. Fetus: Defeat Mom’s Heart for the fifth time
The Wafer: Defeat Mom’s Heart for the seventh time
Money = Power: Defeat Mom’s Heart for the eighth time
The Poop: Defeat It Lives
The Relic: Beat the Womb with Magdalene
Sack of Pennies: Beat the Womb with Cain
Robo-Baby: Beat the Womb with Judas
D6: Beat the Womb with XXX
Razor Blade: Beat the Womb with Eve
Bloody Lust (WotL): Beat the Womb with Samson
Mom’s Knife: Beat Satan with Isaac
Guardian Angel: Beat Satan with Magdalene
Bomb Bag: Beat Satan with Cain
Monster Manual: Beat Satan with Judas
Forget Me Now: Beat Satan with XXX
Demon Baby: Beat Satan with Eve
Blood Rights: Beat Satan with Samson
D20: Complete the Cathedral with Isaac
Celtic Cross: Complete the Cathedral with Magdalene
Abel: Complete the Cathedral with Cain
Curved Horn: Complete the Cathedral with Judas
Sacrificial Dagger: Complete the Cathedral with Eve
Rainbow Baby: Complete the Cathedral with XXX
Bloody Penny: Complete the Cathedral with Samson
The Polaroid: Complete the Cathedral 6 times
Isaac’s Head: Complete the Chest with Isaac
Maggy’s Faith: Complete the Chest with Magdalene
Cain’s Eye: Complete the Chest with Cain
Judas’ Tongue: Complete the Chest with Judas
Eve’s Bird Foot: Complete the Chest with Eve
XXX’s Soul: Complete the Chest with XXX
Samson’s Lock: Complete the Chest with 	Samson
Judas: Defeat Mom’s Heart for the first time
Samson: Defeat Mom after skipping 2 Item Rooms
It Lives: Defeat Mom’s Heart for the ninth time
Sheol: Defeat It Lives (You can access it prematurely if you find an I AM 
ERROR Room, Devil Room or God Room, though I think the last one is a bug, it 
should be a beam of light to the Cathedral), accessed from a trapdoor
Cathedral: Same as Sheol, but without the note, accessed from a beam of 
Chest: Defeat Isaac while holding the Polaroid
Everything is Terrible: Defeat Mom’s Heart for the sixth time

Challenge Rewards:
See Challenges

Yum heart: Have 7 Heart Containers at any given time
Lucky Foot: Have 55 pennies at any given time
Dead Bird: Make 2 deals with the Devil
Super Bandage: defeat 4 Horsemen in the same playthrough
Small Rock: Bomb 50 rocks
The Bean: destroy 50 poop piles
Mr. Mega: Destroy 10 X Rocks
Mom’s Bottle of Pills: Donate blood 20 times
Book of Sin: Defeat all 7 Deadly Sins over multiple playthroughs
Gamekid: Enter 10 Arcades over multiple playthroughs
Necronomicon: Use the Death Tarot Card 4 times
Parasite: Collect any 2 of the following in the same playthrough: Max’s 
Head, Tammy’s Head, Guppy or Bob’s Rotten Head (The wiki also specifies 
Brother Bobby and Dead Bird, but I’m unsure if it’s true)
Shears: Die 100 times
Common Cold: Collect 2 of either The Virus, Roid Rage or Growth Hormones
Mom’s Contact: Collect Mom’s Eye and any other Mom’s Item (Except for Mom’s 
Underwear and Mom’s Bottle of Pills)
Guppy’s Hairball: Transform Isaac into Guppy 
Dad’s Key: Enter the Chest
The Left Hand: Defeat Ultra Pride
Magdalene: Have 7 Heart Containers at the same time
Cain: Have 55 pennies at any given time
Eve: Make 2 deals with the Devil
Steven: Complete the Basement 25 times
C.H.A.D: Complete the Caves 20 times
Gish: Complete the Depths 15 times
Triachnid: Complete the Womb 15 times
Conquest: Destroy 30 X Rocks

C3.7 Curses

At the start of the floor, there’s a chance to get a curse, which makes the 
floor harder in some way.

Curse of the Lost: Increases the size of the floor by some rooms
Not really bad

Curse of Darkness: Makes you unable to see the map

Curse of the Labyrinth: The 2 floors are combined into one big floor (Called 
XL, for example, Cellar XL)
There are 2 Item Rooms and 2 Boss Rooms, both of which must be defeated in 
order to proceed
Sometimes, there might be 2 areas that are only connected by the Secret 
Room. If you have no bombs or Greed spawns in it, then you won’t be able to 
complete the floor

C4.0 Final Words

C4.1 Version History

1.0: Started 15/12/12, temporarily discontinued 31/12/12, continued and 
ended 09/01/13: Finished the guide! :D
1.1: Started and finished 05/02/13: Fixed some mistakes.

C4.2 Contact Info

If you wish to contact me, you can do so by:
My mail (santi_naturalista@hotmail.com)
My YT Account (http://www.youtube.com/user/Lukethehedgehog1), preferably 
this one
If you contact me, make sure that:  
Your message is about the guide
You use proper grammar
You don’t insult me
If you contact me to tell me about a mistake, tell me the name you want to 
be referred as in the Credit section, unless you don’t want credit. If you 
don’t tell me your name, I’ll put your mail. Note that you can contact me 
about practically ANY mistake, even a grammar mistake, but, most 
importantly, tell me about any Item I might have forgotten. Please.

C4.3 Credit

Thanks to:
Edmund McMillen and Florian Himsl for making this game
The Binding of Isaac Wiki, for being such an awesome source of info
My family, for being so supportive with me
Northernlion, from YT, for doing an LP and making me know about this game
You, for reading this guide

C4.4 Legal Information

This may not be reproduced under any circumstance except for personal, 
private use. It may not be posted on any small, personal site, only big 
sites, such as GameFAQs, that I trust. If you see anyone using this guide 
without permission, please tell me, and I’ll put you in the credit section.

C4.5 Closing

So, this guide has come to an end. I don’t think I’ll make any other guide, 
maybe except for the yet unreleased remake of this game: The Binding of 
Isaac: Rebirth

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