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.
Pull a chain and ball behind you that will damage enemies on contact and is able to break stones.
Spawns a portable key master that follows Isaac and collects keys, giving random chests in return.
Grants 5 bombs. Isaac's bombs leave behind fire that damages enemies upon contact.
Grants charged tears that can be fired in a tight burst of four. Getting hit while charging will teleport Isaac into another room.
Adds a chance to shoot concussive tears, causing enemies to walk around randomly.
Spawns a white poop familiar, which turns into a white poop when Isaac is hurt.
Spawns a beggar familiar which floats around the room and picks up any nearby coins, leveling up after collecting several coins. At level 2, Bumbo gains a body. At level 3, it begins to fire tears. At level 4, Bumbo chases enemies slowly, dealing contact damage.
Key Piece 1
Combined with Key Piece 2, unlocks the golden gate in the starting room of The Chest and Dark Room to fight Mega Satan.
Sack of Sacks
Spawns a sack familiar that has a chance to drop a sack upon clearing a room.
Upon entering a room with enemies in it, has a chance to spawn a random charmed enemy that persists across rooms.
Increases damage, but also increases the chance of champion enemies appearing.
Using an activated item while it's not charged will charge it and Sharp Plug does 2 full heart damage to Isaac.
Upon death, the player will respawn as ??? with 3 soul hearts.
Adds a chance to fire a piercing tear that instantly kills any enemy that it touches.
Mom's Coin Purse
Spawns 4 random pills around Isaac.