Afterbirth+ Items


Welcome to The Binding of Isaac item guide. Click on an item to learn more.

Item ID
Icon
Description

YO LISTEN!

492
YO LISTEN!
+1 luck. Spawns a fairy familiar that points out secret room entrances and tinted rocks.
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Varicose Veins

452
Varicose Veins
Taking damage releases a ring of 10 high damage tears.
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Trisagion

533
Trisagion
Tears are replaced with piercing white blasts of light.
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Tonsil

474
Tonsil
Grants a familiar that can block enemy shots.
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Technology Zero

524
Technology Zero
Connects Isaac's tears with electricity that can damage enemies.
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Tarot Cloth

451
Tarot Cloth
Drops a random card or rune. Doubles the effects of cards and runes.
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Sulfuric Acid

463
Sulfuric Acid
Increases damage. Adds a chance to fire acidic tears which can destroy obstacles.
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Slipped Rib

542
Slipped Rib
Spawns a bone familiar that circles around Isaac and reflects enemy shots.
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Sinus Infection

459
Sinus Infection
Adds a chance to fire a booger which sticks to enemies and poisons them.
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Shard of Glass

448
Shard of Glass
Upon taking damage, Isaac has a chance to drop a full red heart, gain 5 range, and leave a trail of damaging red creep for the current room.
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Shade

468
Shade
Spawns a shadow familiar that follows Isaac's movements on a 1 second delay and deals contact damage to enemies.
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Schoolbag

534
Schoolbag
Allows Isaac to hold two active items.
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Sack of Sacks

500
Sack of Sacks
Spawns a sack familiar that has a chance to drop a sack upon clearing a room.
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Pop!

529
Pop!
Replaces Isaac's tears with eyeballs that can bounce off of each other. The eyeballs are not limited by range, and will instead dissipate when they stop moving or when hitting an enemy or obstacle.
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Polydactyly

454
Polydactyly
Allows Isaac to carry two cards, pills, or any combination of both at the same time. Drops a random card or pill.
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Poke Go

505
Poke Go
Upon entering a room with enemies in it, has a chance to spawn a random charmed enemy that persists across rooms.
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Pointy Rib

544
Pointy Rib
Spawns a bone familiar that can be aimed with the fire buttons and does contact damage.
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Parasitoid

461
Parasitoid
Adds a chance to fire an egg sack which spawns slowing creep and spawns a blue fly or spider upon hitting an enemy.
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Mystery Egg

539
Mystery Egg
Spawns an egg familiar, which cracks and turns into a random charmed enemy when Isaac is hurt. The egg regenerates upon entering a different room.
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Mom's Razor

508
Mom's Razor
Spawns an orbiting razor that damages enemies it touches and inflicts bleeding on enemies, causing them to slowly take damage over time.
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Moldy Bread

456
Moldy Bread
Grants one full red heart container.
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Metal Plate

449
Metal Plate
Adds a chance to reflect enemy shots. Grants one soul heart.
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Marrow

541
Marrow
Grants one bone heart and spawns three red heart pickups.
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Marbles

538
Marbles
Spawns 3 random trinkets. Taking damage has a small chance to swallow Isaac's currently held trinket, gaining its effect permanently.
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Little Horn

503
Little Horn
Adds a chance to fire a piercing tear that instantly kills any enemy that it touches.
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Linger Bean

447
Linger Bean
Adds a chance to fire a gas cloud that damages nearby enemies.
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Lil Spewer

537
Lil Spewer
Spawns a random pill, and grants a small Spewer familiar that charges up and fires different types of creep.
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Leprosy

525
Leprosy
Upon taking damage, grants a body part as an orbital, which blocks enemy shots and deals 7 damage per tick to enemies it comes in contact with. The orbitals will be destroyed if they take enough damage from enemies or enemy shots.
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King Baby

472
King Baby
Spawns a familiar that follows Isaac and makes other familiars follow it. While firing tears, it stops moving.
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Hushy

470
Hushy
Spawns a Hush familiar that bounces around the room and deals contact damage. While firing tears, it stops moving.
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Glyph of Balance

464
Glyph of Balance
Grants 2 soul hearts and modifies drops from Champion Monsters based on certain conditions.
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Glaucoma

460
Glaucoma
Adds a chance to shoot concussive tears, causing enemies to walk around randomly.
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Ghost Pepper

495
Ghost Pepper
Adds a chance to shoot a fire that damages enemies and remains in place until it deals enough damage or the room is left.
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Finger!

467
Finger!
Spawns a finger familiar that points at enemies, dealing constant damage.
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Fast Bombs

517
Fast Bombs
Grants 7 bombs and allows bombs to be placed rapidly.
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Eye of Greed

450
Eye of Greed
Adds a chance to fire tears that temporarily stun enemies and turn them into gold. Any enemy killed while in this state will drop coins.
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Eye of Belial

462
Eye of Belial
Grants piercing tears. After piercing one enemy, tears start homing and deal double damage.
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Euthanasia

496
Euthanasia
Adds a chance to fire needles. If a needle kills an enemy, it bursts into more needles.
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Eucharist

499
Eucharist
An Angel Room door will always spawn after every boss fight, excluding the first floor and floors after Utero II/Womb II.
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Duality

498
Duality
Whenever a Devil or Angel Room would spawn after defeating a boss, both rooms spawn. Only one can be entered.
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Dog Tooth

445
Dog Tooth
Increases damage and speed. Upon entering a room adjacent to a secret room, a howl sound effect will play.
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Divorce Papers

547
Divorce Papers
Spawns a Mysterious Paper, increases tears, and grants a bone heart.
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Depression

469
Depression
Spawns a cloud familiar that leaves a trail of tears that damages enemies. Has a chance to spawn damaging beams of light onto enemies that touch the cloud.
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Death's List

530
Death's List
Grants a reward if all enemies in a room are killed in the order they are marked.
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Dead Tooth

446
Dead Tooth
While firing, Isaac gains a green aura that poisons nearby enemies.
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Dark Prince's Crown

442
Dark Prince's Crown
Increases range, tears, and shot speed when at exactly one red heart.
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Dad's Ring

546
Dad's Ring
Creates a ring of light around Isaac that petrifies enemies in contact.
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Dad's Lost Coin

455
Dad's Lost Coin
Increases range by 1.5. Drops a lucky penny.
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Contagion

466
Contagion
The first enemy killed in a room explodes and poisons nearby enemies. Poisoned enemies will also explode upon death.
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Cone Head

457
Cone Head
Grants a soul heart. Adds a chance to block enemy shots.
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