Items

Items are an integral part of gameplay in The Binding of Isaac. They modify a character's stats, grant or modify abilities, and many other things.

Items in general are classified into a number of distinct types and groups. Some items are passive, which add an effect permanently to Isaac, while others only activate when used.

Items dropped in the Binding of Isaac NEVER disappear over time; a coin dropped will remain where it was dropped until you pick it up or leave the floor. A dropped item can be left in its place to be collected at a later time.

Types

Among these types are:

Activated Items

Activated Items fill your spacebar slot. Only one can be carried at a time. An activated item can be used by pressing space, and unlike a pill or card, activated items recharge over time and can be reused when ready. Each item has a unique effect. Most activated items can only appear once per game with few exceptions, so leaving behind an activated item is typically a permanent choice.

Passives

These Items, when picked up, add a permanent effect to Isaac. These cannot be removed and are individually counted on the collection screen. Collectible items can be obtained in a variety of ways and most are unique in that, once appearing in game, they will never appear again during that session.

Pills

These go into your Q slot and are one-time-use items. There are a number of different pill styles and effects. At the start of the game, each type is randomly assigned an effect, which remains bound to that pill style for the remainder of that game. Pills start unidentified and are identified once used, unless the player has the PHD item, which identifies pills after a short delay. Picking up a pill or card while you already have one causes the old one to be dropped.

Tarot Cards

Tarot Cards are also Q slot items, and are also one-time use. Tarot Cards are unidentified when dropped and immediately identified when picked up. Each card has a unique and pre-determined effect. Picking up a pill or card while already carrying one causes the old one to be dropped.

Trinkets

Trinkets fill their own slot and are passive items that affect Isaac in unique ways. Only one can be carried at a time (Unless the player has Mom's Purse, which allows Isaac to hold two Trinkets at once); taking another will replace the current trinket and drop the old one.

Pick Ups

These are common items dropped in game and, when taken automatically confer their effect. This category includes items such as coins, hearts, keys and bombs and disappear once picked up.

Collectibles

There are 198 different collectible items in the game. Below is a list of all of the collectibles, separated into categories. Certain collectibles change the appearance of your character when they are acquired. Collectibles you've found can be seen in the Collection page.

Activated Collectibles

These items are stored in the Spacebar slot and are used up once the button is pressed. The items then recharge in one of two ways. Normally, they charge a number of bars after every room you clear—some items charge one bar at a time, others charge faster. Note that only rooms where the doors close until they are cleared count—Bosses, arenas, enemy rooms, etc. The Collectible Item "Battery" can give bars of charge during combat, on top of the normal recharge. Another Collectible Item, the "9 Volt", will automatically recharge 2 bars when an item is used; this effectively reduces the number of rooms required to charge an item if the item requires 3 or more rooms to charge. In the Wrath of the Lamb DLC, there is another item, the Habit, which will recharge bars when taking damage. To see a clearer version of the in-game arrangement, go to the Collection page.

Note: Any two of the same activated item on the same floor will share charge state, i.e. Finding another of the same activated item when one is not fully charged will not give the player another fully charged version of the item. This can be observed in the Library, which can spawn 2 of the same book.

Item	Icon	Effect	Recharge Time
Anarchist Cookbook		Spawns six troll bombs around the room.	3
The Bean		Causes Isaac to have bad gas, poisoning any enemy in close vicinity.	1
Bob's Rotten Head		Throws a bomb in the direction Isaac's facing. It does extreme damage, poisons the enemy for 5 seconds, and destroys rocks.	3
The Bible		Upon activation, Isaac gains Flight, allowing him to pass over all obstacles in the current room. Instantly kills Mom, Mom's Heart and It Lives when activated, will kill Isaac when activated while fighting Satan, Isaac or ??? unless he has The Wafer.	6
The Book Of Belial		Adds 2 points of damage for the current room. Damage is further multiplied by 1.5x with the Blood Of The Martyr item. Also increases chances of a Devil Room spawning by 25%.	3
Book Of Revelations		Adds 1 Soul Heart and makes the next boss a Horseman (except on XL Floors and on floors with fixed bosses such as Mom). Increases chances of a Devil Room spawning by 35%.	6
Book Of Shadows		Grants Isaac invulnerability for 10 seconds.	3
The Book Of Sin		Spawns a random Pick Up, Pill or Card.	4
Dead Sea Scrolls		Uses a random Activated Item.	4
Deck of Cards		Gives Isaac a random Tarot Card.	6
The Dice		Allows Isaac to re-roll collectible items in the current room into other items, depending on the current room's Item Pool.	3
Doctor's Remote		Sets a big red target on the ground (similar to the Epic Fetus item) which can be controlled with the arrow keys or the mouse. After 6 seconds or by pressing space again, a huge explosive missile hits it, which damages all enemies caught in its blast radius.	3
Forget Me Now		When activated, the level ends and is freshly regenerated with new rooms, monsters, and items. Disappears after use.	One-time use
The Gamekid		Isaac turns into a Pac-Man-like creature for 5 seconds, gaining invincibility, +0.28 Speed, and the ability to damage enemies by touch, restoring a half-heart of health for every 2 enemies killed. Enemies will also turn blue and start fleeing from Isaac for the duration of the effect.	6
The Hourglass		Upon activation, enemies and their projectiles are slowed down for 7.67 seconds.	2
Kamikaze!		Creates an explosion in the same area as Isaac, dealing one heart of damage to him and also damaging all enemies caught in the blast radius.	0
Lemon Mishap		Creates a small yellow pool of Creep, which damages enemies that cross it.	2
Mom's Bottle Of Pills		Gives Isaac a random Pill, and will cause him to drop any held Q-slot item (If any). The player will only receive six different pill types in one playthrough.	6
Mom's Bra		Causes Isaac to wear a bra on his head for a short period of time, which freezes enemies for 5 seconds.	3
Mom's Pad		Causes enemies to back away from Isaac for 5 seconds.	3
Monster Manuel		Summons a random familiar for the current room only, even if it is locked.	4
Monstro's Tooth		Monstro jumps onto a random enemy, doing damage. Cannot be used in a fight against Monstro, but can be used against Monstro II.	3
Mr. Boom		Drops a large bomb.	2
My Little Unicorn		Grants Isaac invincibility for a short period of time. Isaac cannot fire tears during the invincibility effect, but he can damage enemies by touch. Increases Speed by 0.28 for the duration of the effect.	6
The Nail		On activation, adds one Soul Heart and allows the breaking of Rocks and damaging enemies by simply walking over them. Increases Damage by 0.7 and decreases Speed by 0.18 for current room.	6
The Necronomicon		Damages all enemies in the room significantly.	6
A Pony		Upon use, Isaac will charge in the direction selected, and will become invincible during the charge, allowing him to damage enemies by touch. While equipped, passively increases Speed to a minimum of 1.5, and grants Isaac Flight.	4
The Poop		Drops a pile of poop at his current location. This pile of poop may yield Hearts or Coins like regular poop.	1
Razor Blade		Deals 1 Heart of damage to Isaac, which increases damage for the current room.	0
The Pinking Shears		Separates Isaac's head and body for the current room. Isaac's head will be controlled, which now has Flight, while his body will seek out enemies to attack by contact damage.	6
Shoop Da Whoop!		Fires a laser from Isaac's mouth.	3
Tammy's Head		Shoots 10 tears in a circle around Isaac, which retain the size (damage), shot speed, and special effects (such as Poison) of Isaac's tears. The tears are not affected by tear-replacing items like Brimstone.	1
Teleport!		Teleports Isaac to a random room on the current floor.	2
We Need To Go Deeper!		Creates a trapdoor to go to the next floor. If used in The Womb, it will create a trapdoor to Sheol, even if the player hasn't unlocked it. Does not work in Sheol, The Cathedral, or The Chest.	6
Yum Heart		Restores 1 whole heart.	4

Wrath of the Lamb Activated Collectibles

The following activated items can only be acquired in the Wrath of the Lamb DLC.

Item	Icon	Effect	Recharge Time
Best Friend		Deploys a decoy Isaac that eventually explodes with an increased blast radius. Like all explosive attacks, the explosion can hurt Isaac if he is within the blast radius.	3
Blood Rights		Deals a half-heart of damage to Isaac, which damages all enemies in the room.	0
The Candle		Throws out a blue flame that can pass over gaps (but not through rocks) that damages anything in its path. Recharges 3 seconds after firing.	Recharges itself
Crack The Sky		Summons multiple beams of light in random locations around the room, dealing a large amount of damage to any enemy that touches them.	4
Crystal Ball		Reveals the map and drops a random Tarot Card or Soul Heart.	6
D20		Randomly changes all Pick Ups in the current room.	6
Dad's Key		Opens all doors in the current room when activated, except rooms which require a Key to open, such as Treasure Rooms and Libraries.	2
Guppy's Head		Spawns 2-4 Blue Flies to damage enemies.	1
Guppy's Paw		Removes one Heart Container in exchange for gaining 3 Soul Hearts.	0
IV Bag		Upon activation, Isaac loses a half-heart (one whole heart in The Womb and onwards) for a random amount of coins, similar to the Blood Donation Machine.	0
Notched Axe		Breaks a single rock when activated.	1
Portable Slot		Upon activation, 1 coin will be consumed, and a random Pick Up may drop, similar to the Slot Machine.	0
Prayer Card		Grants half an Eternal Heart per use.	6
Remote Detonator		Bombs you place explode only when you use this item. Gives 5 bombs.	0
Spider Butt		Damages all enemies in the room and and slows them and their projectiles down for 2.5 seconds (similar to The Hourglass).	2
Telepathy For Dummies		Gives Isaac homing tears for the current room. (Identical to Spoon Bender)	2
White Pony		Upon use, Isaac will become invincible and charge in the direction selected, dealing damage to monsters touched. In addition, beams of light (similar to Crack The Sky) drop down in random locations around the room, damaging any enemies that touch them. While equipped, increases Speed up to a minimum of 1.5, and grants Isaac Flight.	6

Passive Collectibles

These items generally give you some kind of a boost to your stats, or add a special passive ability. They take effect immediately once picked up, and continue for the rest of the game (except for several items that do not provide any lasting effect).

Edmund McMillen split them up in his blog into the subcategories "weapon items" (Such as Number One), "stat padding items" (Such as Growth Hormones), "passive items" (Such as Mitre), and Familiars (Such as Little Gish).

Item	Icon	Effect
<3		Increases available heart containers by 1 and restores all health.
1UP		Gives an extra life. Upon death, you will respawn in the previous room with full health and lose the 1UP.
9 Volt		Leaves Isaac with two bars already charged after using an item. Upon pickup, Isaac's current activated item will be fully charged.
The Battery		Gives Isaac an extra charge every 15 seconds per room, up to a maximum of 3 charges.
The Belt		Increases Speed by 2.
Blood Bag		Increases HP by 1, Speed by 0.3, and restores 4 hearts. More than one can be obtained during a same playthrough
Blood Of The Martyr		Increases Damage by 1, and turns Isaac's tears into blood tears. If collected with the The Book of Belial, damage will also be multiplied by 1.5x upon activation.
Bobby-Bomb		Gives Isaac 5 Bombs, and causes all dropped bombs to home towards the closest enemy.
Bomb Bag		Isaac is followed by a small bag that drops a Bomb, 1+1 Free, or a Troll Bomb every 3 rooms.
Boom!		Gives 10 bombs.
Breakfast		Increases HP by 1.
Brimstone		Changes tears to a chargeable laser, which pierces all objects in its path. Also multiplies damage by 3. It can only be fired after a short charge-up period.
Brother Bobby		Follows Isaac around shooting normal tears.
Bucket Of Lard		Gives two empty heart containers, heals by half a heart but decreases speed by 1.
Charm Of The Vampire		Killing 13 monsters heals the player for half a heart.
Chocolate Milk		Allows Isaac to charge shots, making them a lot stronger and larger, and turns them brown. Tears will no longer automatically fire while holding down arrow keys.
The Common Cold		Gives Isaac's shot a chance of poisoning enemies for a 2.5 seconds, and turns tears green.
The Compass		Reveals all special rooms (Boss Rooms, Treasure Rooms, Shops, etc.), but not Secret Rooms/Super Secret Rooms or regular rooms.
Cube Of Meat		The first pick up gives a floating cube similar to a Pretty Fly that damages enemies and blocks shots. The second pick up changes it into a floating head that shoots red tears and blocks shots. The third pick up changes it into a humanoid Meat Boy, who walks around chasing enemies, but no longer shoot projectiles. (This stage and the last stage can push bombs around, which can damage Isaac if the player is not careful) The fourth pick up increases his size and damage. A fifth pick up will create another cube of meat orbital which then advances to another Super Meat Boy. However, it is not possible to have three or more Meat Boys, as the ninth cube will simply disappear on pickup. → →→
Cupid's Arrow		Gives Isaac piercing tears that can travel through enemies. Removes knockback effect of tears.
Dead Bird		Whenever Isaac takes damage, the bird starts attacking nearby enemies while flying over obstacles. The effect only lasts for the current room.
Dead Cat		Your HP is set to 1. You are followed by a floating cat head and have 9 lives (these still count as deaths on the statistics screen). You can increase your max HP as normal, but after each death it will reset to 1 again.
Dessert		Increases available heart containers by 1.
Dinner		Increases available heart containers by 1.
Distant Admiration		A red attack fly circles further out than the Halo of Flies/Pretty Flies, but closer than Forever Alone. Deals more damage than Forever Alone.
Demon Baby		Follows Isaac and automatically fires at enemies in its reach.
A Dollar		Gives Isaac 99 coins. Can be found multiple times in a single playthrough.
Dr. Fetus		Replaces Isaac's shot with a bomb. Only one bomb can be shot at a time, and it will slide a fixed range before exploding.
Forever Alone		Spawns a blue attack fly that orbits a long distance from Isaac.
Growth Hormones		Increase Speed and Damage by 2 each.
Guardian Angel		Spawns a Guardian Angel that orbits Isaac. Does damage on touch, blocks shots and doubles the speed of other orbitals.
The Halo		Increases all stats (Including Heart Containers) by one.
Halo Of Flies		Grants 2 Fly orbitals that circle Isaac. Blocks shots and damages Fly enemies on touch.
The Inner Eye		Gives Isaac a triple shot, sets Tears to minimum
The Ladder		Allows Isaac to walk across gaps one square across by automatically placing a ladder between the two walkables.
Little C.H.A.D.		Isaac is followed by Little C.H.A.D, who will drop a half Heart every 2 rooms.
Little Chubby		Adds a small grub that follows Isaac. Charges forward and deals touch damage to any enemies in her path. Will attack when the Isaac attacks with a moderate cooldown time before she can attack again.
Little Gish		Follows Isaac around shooting tar projectiles that reduce enemies' movement speed, shot speed, and range for a few seconds.
Little Steve		Follows Isaac around, shooting homing projectiles.
Loki's Horns		Gives a random chance for projectiles to fire in a cross (+) pattern.
Lord Of The Pit		Isaac can fly over all obstacles, including damage floors, spikes, rocks, and pits. Increases speed by 1.
Lucky Foot		All Pills picked up will have positive or neutral effects (same effect as the PHD, but without pill identification and neutral pills). Increases the chance of getting Pick Ups from clearing a room or from Poop and Fireplaces. Increases the chance of winning the Shell game in the Arcade room from 33% to roughly 50%. Increases the chances of getting items from Golden Chests.
Lunch		Increases available heart containers by 1.
A Lump Of Coal		Increases damage of tears based on amount of time in the air. 0.14 damage per frame, or 4.2 damage per second.(tear size increases as it gets further away).
Magic Mushroom		Fully heals Isaac, increases all Stats (excluding Rate Of Fire) by 1, and multiplies damage by 1.5x.
Magneto		Pulls Pick Ups towards Isaac.
The Mark		Increases Damage by 1, Speed by 0.2, and adds one Soul Heart.
Max's Head		Increases damage by 1, and multiplies it by 1.5x.
Mini Mushroom		Increases Speed and Range by 1.
Mom's Contacts		Gives Isaac a petrifying shot that will randomly freeze enemies solid for a few seconds.
Mom's Eye		Allows Isaac to fire tears from the back of his head.
Mom's Heels		Increases Range by 7.75.
Mom's Knife		Once collected, Isaac no longer shoots tears, he shoots a knife in boomerang style. The range of throw increases by charging the shot. Can also be used as a melee weapon while not fired.
Mom's Lipstick		Increases Range by 7.75.
Mom's Underwear		Increases Range by 7.75.
Money = Power		Increases damage based on the number of coins the player has at the moment.
Mr. Mega		Gives Isaac 5 bombs, and makes all dropped bombs larger (Similar to the bomb dropped by Mr. Boom), which have an increased blast radius and increased damage.
My Reflection		Gives Isaac's tears a boomerang effect, and sets range to default.
Number One		Sets Isaac's tears to their maximum rate of fire and minimum range.
Odd Mushroom (Large)		Increases damage by 0.3, adds an empty Heart Container, increases range by 2.75 and reduces Speed by 0.1.
Odd Mushroom (Thin)		Increases Speed by 1, sets Rate Of Fire to maximum while reducing Damage by 1.
Ouija Board		Turns Isaac's tears spectral, allowing them to go through rocks or obstacles.
The Pact		Increases Damage by 0.5 and Rate Of Fire by 0.7. The player also gains 2 Soul Hearts.
The Parasite		Makes the Isaac's tears split in two when they hit something.
Pentagram		Increases Damage by 1 and increases chances of the Devil Room appearing by 20%..
PHD		Changes negative Pill effects into positive ones. Also causes Blood Donation Machines to drop more money. Restores 2 hearts upon pickup.
A Quarter		Gives you 25 pennies.
Raw Liver		Increases available Heart Containers by 2 and completely restores health.
The Relic		Isaac is followed by a small blue cross that will drop a Soul Heart every 5 rooms.
Robo-Baby		Follows Isaac around, shooting enemies with an eye laser similar to Technology.
Roid Rage		Increases Speed by 0.6. Does NOT increase range.
Rosary		Adds 3 Soul Hearts and increases the chance for The Bible to appear in the Shop.
Rotten Meat		Increases available heart containers by 1.
Sack Of Pennies		Isaac is followed by a small bag that drops a coin every 2 rooms. Usually a penny, sometimes a nickel.
The Sad Onion		Increases tears by 0.7.
Sister Maggy		Follows Isaac around shooting blood tears.
Skatole		All the various fly type enemies no longer harm you, shoot, or split.
Skeleton Key		Sets your key count to the maximum of 99.
The Small Rock		Increases damage by 1, increases tears by 0.2, decreases speed by 0.2.
Spelunker Hat		Reveals the Secret Room and Top Secret Room when passing by it and reveals if a room contains a mini-boss.
Spider's Bite		Gives Isaac's shots a chance of slowing enemies for 2.5 seconds.
Spoon Bender		Gives Isaac's shots the ability to curve towards enemies.
Steam Sale		Reduces all Shop prices by 50%, rounded down when an item, rounded up when a pickup.
Steven		Increases Damage by 1.
Super Bandage		Increases HP by 1 and gives 2 soul hearts.
Technology		Gives Isaac a laser shot with unlimited range. Shots pierce enemies but not rocks, fire, or poop. Shots can't be angled, and will not provide knockback.
Transcendence		Removes Isaac's body, allowing flight over obstacles, spikes and pits.
Treasure Map		Reveals all rooms for every floor, including the Secret Room. However, it does not reveal icons.
The Virus		Isaac will automatically poison any enemy that he touches.
The Wafer		Turns all types of damage into a half-heart, including damage taken in The Womb and onwards.
Whore Of Babylon		When Isaac reaches a half-heart, he is given +2.16 damage, and his speed increases by 0.3.
Wiggle Worm		Gives Isaac waving shots and increases Rate Of Fire by 0.4.
Wire Coat Hanger		Increases Tears by 0.7.
Wooden Spoon		Increases speed by 0.3.
XRay Vision		Reveals and opens Secret Room entrances.

Wrath of the Lamb Passive Collectibles

The following collectible items can only be acquired if you have the Wrath of the Lamb DLC.

Item	Icon	Effect
3 Dollar Bill		Effect given changes every room.
Abel		Mirrors Isaac's movements. Shoots in opposite direction to the player.
Ankh		When killed, respawns in the previous room as ???, regardless of the fact he is unlocked or not. After respawn, all future HP upgrades will be soul hearts only. Only works once.
The Black Bean		When taking damage, Isaac farts, causing poison damage to all enemies in range.
Bloody Lust		Increases damage each time Isaac kills an enemy for the current room. (.28 damage per kill, caps at 3.3.)
Bob's Curse		Gives 5 bombs and grants all bombs poison effect.
Box		Spawns 1 of each item: 1 coin, 1 key, 1 bomb, 1 heart, 1 card, 1 pill, 1 trinket.
Bum Friend		A portable Beggar who follows Isaac, pick up coins for himself, and occasionally drop Pick Ups. Does not spawn Collectibles. Can push around dropped bombs, similar to Meat Boy.
Cat-O-Nine-Tails		Increases Shot Speed by 23%.
Celtic Cross		Has a 20% to create a protective shield around Isaac upon taking damage, which grants him invulnerability to all forms of damage for 7 seconds.
Chemical Peel		Tears fired from left eye do increased damage.
Daddy's Love		Daddy Long Legs' shadow follows Isaac and stomps on enemies.
Dead Dove		Gives Isaac spectral tears and flight.
Epic Fetus		Tears become guided missiles (See Doctor's Remote).
Fate		Isaac gains flight and an Eternal Heart.
Ghost Baby		Familiar that shoots spectral tears.
Guppy's Hair Ball		Loosely follows behind Isaac. Can be swung like a flail by rapidly spinning Isaac in a circle. Grows bigger by killing enemies
Guppy's Tail		Increases chance of gold chests and normal chests.
Habit		When Isaac is hit, 3 points of an item's charge are filled.
Harlequin Baby		Familiar that shoots a pair of tears diagonally every second while Isaac is firing.
Holy Grail		Adds 1 empty heart container and gives flying ability.
Holy Water		When Isaac receives damage, the bottle breaks and a puddle of blue Creep forms, which damages non-flying enemies, similar to Lemon Mishap. The bottle is reformed upon entering a different room.
Infestation		1-3 Blue Flies randomly spawn every time Isaac gets hit.
Ipecac		Green projectiles fired from the mouth causing poison/explosive damage.
Jesus Juice		Increases Damage by 0.5 and increases Range.
Magic 8 Ball		Increases Shot Speed. Drops a Tarot Card when picked up.
MEAT!		Adds a heart container, and increases damage.
Mitre		Greatly increases the chance of replacing spawned hearts with soul hearts.
Mom's Coin Purse		Spawns 4 random Pills around Isaac.
Mom's Purse		Allows Isaac to hold 1 additional trinket.
The Mulligan		Chance to spawn Blue Flies on successful hits, which charge current target.
Mutant Spider		Shoot four tears at once, greatly reduces tear firing rate.
Pageant Boy		Spawns several coins around Isaac.
The Peeper		Gives Isaac a familiar eye that floats around the room, damaging enemies on contact Tears fired from left eye become red (cosmetic only)
Polyphemus		Makes Isaac shoot one huge tear. Also reduces Tears to minimum. Damage increased by 4 and then multiplied by 2. If tear does more damage than an enemy's life, the tear continues to travel with the extra remaining damage.
Pyro		Adds 99 Bombs.
Rainbow Baby		Tear Effect changes every shot.
Sacred Heart		Shots are larger, travel slower and home in on enemies. Damage is multiplied. (Multiplies damage by X2.3+1, -0.4 tears, -0.25 shot speed.) Gives 1 Soul Heart and restores full Health on Pick up.
Sacrificial Dagger		Dagger orbits Isaac, very high damage.
Scapular		Once per room, when Isaac is reduced to his last half red Heart, the aura around his head temporarily vanishes and he is granted one Soul Heart.
SMB Super Fan!		Increases all stats except Speed by 1. Reduces Speed by 1.
Speed Ball		Increases movement speed and causes tears to travel faster.
Spirit Of The Night		Grants Isaac flight and spectral tears.
Squeezy		+1 tears and spawns 2 soul hearts.
Stem Cells		Adds an extra Heart Container, heals a half heart, and increases Shot Speed.
Stigmata		Boosts Isaac's damage by 0.3 and grants you one heart container.
Technology 2		Fires a continuous laser as you shoot tears. Decreases your damage by -35%. Pierces enemies.
Toothpicks		Increases shot speed.
Tough Love		Isaac randomly shoots teeth instead of tears, dealing 3.2 times his normal damage.