Item: Cone Head

Spawns a familiar that follows Isaac around and blocks enemy projectiles. Upon blocking a shot, it has a chance of triggering The Necronomicon effect.

Allows Isaac to fire tears from the back of his head.

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

Grants two empty heart containers and heals Isaac by half a heart, but decreases speed by 0.2.

Wanders about the room, occasionally spawning blue spiders.

Has a chance of spawning a soul heart or black heart when taking damage. Enemies have a chance to drop a Half Red Heart after being killed.

A familiar that follows Isaac around shooting blood tears.

If the character has half a red heart or no red hearts after taking damage, it triggers the Book Of Shadows effect, creating a shield that nullifies all types of damage for 5 seconds. Also allows entrance into The Chest.

+2.25 Range Up. +1.5 Tear Height. Isaac's tears travel through walls and appear out of the opposite wall. Isaac's tears also travel over rocks and objects.

Grants Isaac one full red heart container.

Randomly while firing tears, Isaac will stop firing and turn red, where he will charge and release a lot of 'tears' in one go. In the burst of tears is a kidney stone which deals a lot of damage.

Increases Damage by 1.5, reduces Tears by 0.3 and increases tear size. Grants piercing tears. Tears are replaced by Death's scythes, which is a cosmetic effect only.

Grants one Heart Container and gives 2 Soul Hearts.

Increases speed by 0.6, range by 5.25, and tear height by 0.5.

Upon entering a room, poisons all enemies, dealing double Isaac's tear damage. Killing enemies leaves a small, short lasting pool of green creep on the ground.

Isaac has a random chance to fire a Holy tear, which, when it hits an enemy, will spawn a Crack the Sky-style light beam on the same enemy, dealing damage.

Spawns a chest familiar that follows Isaac and drops a random pickup every few rooms.

Whenever Isaac takes damage, a black ring briefly appears around Isaac, dealing damage to all nearby enemies.

While Isaac has no red hearts, this item grants flight and a random chance to activate an invincibility shield for a few seconds. If Isaac gains any red hearts, these benefits will disappear.

Doubles damage, halves tears stat, and greatly reduces shot speed.