Binding of Isaac Achievement: Marrow

Use I - The Magician or Telepathy for Dummies while already having homing tears (Sources of this effect include I - The Magician, Telepathy for Dummies, Spoon Bender, Sacred Heart, or Godhead).

Acquire Blood Clot 10 times

Defeat The Lamb for the 1st time

Defeat Ultra Greedier as Keeper

Take 50 devil deals

Complete the Boss Rush as The Forgotten

Defeat The Lamb without taking hearts, coins, and bombs through an entire run

Defeat Ultra Greedier as Azazel

Beat Chapter 4 without taking damage

Collect every entry in the Bestiary (Bugged v190 - Mobs that don't exist in the bestiary are being counted. This allows Sin Collector to be unlocked without a complete bestiary)

Take 25 items from Angel rooms

Participate in 31 Daily Challenges (they don't have to be consecutive; it will still count if you die in the first room)

Increase in size 5 times in a single run. Sources of increased size include "One Makes you Larger" pills, XI - Strength, and Magic Mushroom

Defeat Hush for the 1st time

Defeat Mom's Heart 11 times

Defeat Isaac as Apollyon

Earn all Hard Mode Completion Marks as Apollyon

Use cards and runes 20 times

Defeat Satan as The Forgotten

Defeat Delirium as The Lost