Item: Little Gish

Grants a chance to trigger the Book of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 7 seconds.

Increases damage, but also increases the chance of champion enemies appearing.

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.

Increases Tears by 0.7.

Grants Isaac one full red heart container.

Gives an extra life. Upon death, you will respawn in the previous room with full health and lose the 1up!.

Grants 5 bombs. Isaac's bombs leave behind fire that damages enemies upon contact.

Increases tears. Adds a chance to fire a high-damage razor blade.

Spawns a Mysterious Paper, increases tears, and grants a bone heart.

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

+0.25 Speed. Running into enemies while at a high speed will deal 18 points of damage. Does not prevent contact damage.

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.

Tears + Shot speed up.

Grants two soul hearts. Isaac now repels enemy projectiles.

Tears simultaneously fire out of both eyes diagonally, similar to the effect of the R U A Wizard?pill. Isaac's tears also travel above all obstacles.

Grants a familiar that transforms into another random familiar every 10 seconds.

Grants 7 bombs and allows bombs to be placed rapidly.

Adds one heart container and drops a random trinket.

Increases the size of blue spiders and Blue Flies and doubles the amount of damage they deal.

Grants one Heart Container and gives 2 Soul Hearts.