Teleports Isaac back to the starting room of a floor.

Unlock method: Always available

Grants homing tears and +3 range for the current room (same effect as Telepathy for Dummies).

Unlock method: Always available

Mom's dismembered leg is called down to deal 300 damage to anything it stomps. It will always stomp on the enemy with the most health. If used in an empty room or during the fight with Mom, it will stomp Isaac instead.

Unlock method: Always available

Triggers the Whore of Babylon effect (+1.5 damage, +0.3 speed) for the current room, but without the need for Isaac to have a red heart or less of health.

Unlock method: Always available

Teleports Isaac into the Boss Room of a floor.

Unlock method: Always available

Spawns 2 Soul Hearts.

Unlock method: Always available

Spawns 2 Red Hearts. If used in a Black Heart or Eternal Heart-containing Super Secret Room, it will spawn those types of hearts instead.

Unlock method: Always available

Grants the temporary invulnerability effect of My Little Unicorn.

Unlock method: Always available

Spawns one of each consumable drop (a Red Heart, a Key, a Bomb, and a Penny). Hearts have a chance to spawn as either a Half Red Heart or a Double Heart.

Unlock method: Always available

Teleports Isaac to the Shop. If there is no Shop, this will act as a random teleport. If the Shop has not yet been accessed, this card will unlock the door without requiring a key (as long as the player exits through the main entrance).

Unlock method: Always available

Spawns an Arcade machine (Slot Machine or Fortune Telling Machine).

Unlock method: Always available

Grants the effect of Magic Mushroom (increases all of Isaac's stats except tears), but adds one (temporary) Red Heart container for the current room as opposed to a permanent one and does not restore health like Magic Mushroom does.

Unlock method: Always available

Removes Isaac's body, allowing him to fly around for the duration of the room (same effect as Transcendence).

Unlock method: Always available

Deals 40 damage to all enemies in the room (same effect as The Necronomicon).

Unlock method: Always available

Spawns a Blood Donation Machine. Spawns a Devil Beggar in Greed mode.

Unlock method: Always available

Grants Isaac a temporary +2 increase to damage for the current room (same effect as The Book of Belial).

Unlock method: Always available

Spawns 6 Troll Bombs randomly around the room (same effect as the Anarchist Cookbook).

Unlock method: Always available

Teleports Isaac to the Treasure Room. If there is no Treasure Room, this will act as a random teleport. Randomly chooses a Treasure Room on Curse of the Labyrinth. If the Treasure Room has not yet been accessed, this card will unlock the door without requiring a key (as long as the player exits through the main entrance). Can also teleport Isaac to the Planetarium.

Unlock method: Always available

Teleports the player to the Secret Room. This card will open one random wall once inside the Secret Room, so you can leave even if you don't have any bombs available.

Unlock method: Always available

Restores Isaac's full health, deals 100 damage to all enemies in the room, and reveals the map for the current floor, except the Super Secret Room. Removes Curse of Darkness for the current floor.

Unlock method: Always available

Spawns a Beggar.

Unlock method: Always available

Reveals the entire floor, except for the Super Secret Room. Has no effect if under the effect of Curse of the Lost or Amnesia.

Unlock method: Always available

Let go and move on

Drops all hearts and pickups on the floor, leaving Isaac at half a heart. Pickups may be spawned as items such as A Quarter and Boom!.

Unlock method: Defeat Ultra Greedier as Tainted Lost

May no harm come to you

Grants a repelling blue aura for one minute, like The Soul but stronger and with a wider area of effect.

Unlock method: Defeat Ultra Greedier as Tainted Judas

Run

Mom's leg starts stomping down repeatedly for one minute, like holding Broken Shovel.

Unlock method: Defeat Ultra Greedier as Tainted Lilith

May your love bring protection

Grants 2 temporary red heart containers and +1.35 tears for one minute, along with Magdalene's hairstyle. Does not stack.

Unlock method: Defeat Ultra Greedier as Tainted Eve

May you find a worthy opponent

Teleports Isaac into an extra Boss Room. The boss will drop a reward, but the room has no trapdoor so Isaac cannot enter the next floor. The room has an exit door, which leads Isaac back to where he used IV - The Emperor?.

Unlock method: Defeat Ultra Greedier as Tainted ???

Two prayers for the forgotten

Spawns 2 Bone Hearts.

Unlock method: Defeat Ultra Greedier as Tainted Bethany

May your heart shatter to pieces

Spawns a random item from the current room's item pool. Turns 1 red heart container or 2 soul hearts into a broken heart, potentially fatally; no downside for any character who has no health bar.

Unlock method: Defeat Ultra Greedier as Tainted Magdalene

May nothing walk past you

Isaac becomes an invincible, immobile statue with extreme fire rate for 10 seconds. Sometimes the statue looks like Edith.

Unlock method: Complete Hot Potato (challenge #42)

May your sins come back to torment you

Spawns 2 to 4 Golden Chests.

Unlock method: Complete Cantripped (challenge #43)

May you see the value of all things in life

"Sells" items and pickups in the room for their usual shop price, spawning a matching amount of coins. Does not affect grab bags. If there is nothing to sell, spawns a penny.

Unlock method: Complete Red Redemption (challenge #44)

Throw the dice of fate

Invokes a random dice room effect.

Unlock method: Defeat Ultra Greedier as Tainted Cain

May you break their resolve

All enemies in the room are weakened, becoming slow and take double damage. The effect lasts up to one minute or until the room is left.

Unlock method: Defeat Ultra Greedier as Tainted Samson

May your greed know no bounds

Isaac turns visually into Keeper for 30 seconds, with a triple shot, no damage bonus and -0.1 speed. Killed enemies drop random coins.

Unlock method: Defeat Ultra Greedier as Tainted Keeper

May life spring forth from the fallen

Invokes a Book of the Dead effect.

Unlock method: Defeat Ultra Greedier as Tainted Forgotten

May your hunger be satiated

Forces Isaac to eat 5 random pills in quick succession.

Unlock method: Complete DELETE THIS (challenge #45)

Bask in the light of your mercy

Invokes The Bible, giving Isaac flight, and grants a Seraphim familiar for 30 seconds.

Unlock method: Defeat Ultra Greedier as Tainted Azazel

Creation brings destruction

Spawns 6 clusters of random rocks and other obstacles. Spawned clusters will often contain tinted rocks. The pathways between exits can't be blocked.

Unlock method: Defeat Ultra Greedier as Tainted Apollyon

May your loss bring fortune

Removes Isaac's oldest passive item and spawns 2 random items from the current room's item pool.

Unlock method: Defeat Ultra Greedier as Tainted Isaac

May you remember lost memories

Teleports the player to the Ultra Secret Room. The pathway back to the normal rooms will be made of red rooms.

Unlock method: Defeat Ultra Greedier as Tainted Jacob

May the darkness swallow all around you

Gain Spirit of the Night and +1.5 damage for the current level. Turns Isaac's red hearts into bone hearts, but they revert once the effect ends. Also causes Curse of Darkness that cannot be dispelled.

Unlock method: Defeat Ultra Greedier as Tainted Jacob

May you redeem those found wanting

Spawns a Restock Machine.

Unlock method: Defeat Ultra Greedier as Tainted Lazarus

Step into the abyss

Spawns a trap door to a crawl space.

Unlock method: Defeat Ultra Greedier as Tainted Eden

Item multiplier

Doubles your bombs. If you have no bombs, gives you 2 instead.

Unlock method: Always available

Item multiplier

Doubles your coins. If you have no coins, gives you 2 instead.

Unlock method: Always available

Item multiplier

Doubles your keys. If you have no keys, gives you 2 instead.

Unlock method: Always available

Item multiplier

Doubles Isaac's current number of Red Hearts. Does not affect Eternal Hearts, Soul Hearts, or Black Hearts. Doesn't add new Red Heart containers, just fills empty ones.

Unlock method: Always available

Convert all

Turns all pickups, chests, and non-boss enemies in the room into Bombs.

Unlock method: Get a 3-win streak

Convert all

Turns all pickups, chests, and non-boss enemies in the room into Pennies.

Unlock method: Defeat The Lamb in under 20 minutes

Convert all

Turns all pickups, chests, and non-boss enemies in the room into Keys.

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

Convert all

Turns all pickups, chests, and non-boss enemies in the room into random heart pickups.

Unlock method: Complete a Chapter (floors I and II) after The Basement, start-to-finish, with only half a heart of health (can use The Lost)

???

Teleports Isaac to the Devil Room or Angel Room.

Unlock method: Always available

A true ending?

Kills Isaac and spawns lots of pickups, items, and/or chests in the same room.

Unlock method: Complete Suicide King (challenge #7)

<3

Spawns 1-12 full red hearts.

Unlock method: Defeat Mega Satan as Tainted Magdalene

???

Throws the card to kill anything in its path. Opens normal doors.

Unlock method: Complete Demo Man (challenge #9)

Become immense!

Makes Isaac large for the current room, increasing his range and damage.

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

Draw 3 cards

Spawns 3 random cards.

Unlock method: Use cards and runes 20 times

Savor the moment

For the current room, enemies are slowed, Isaac's speed is increased, and his shot speed is decreased.

Unlock method: Have both the Broken Watch and the Stop Watch in your collection

Charge it!

Converts all items in the Shop or Devil Room into pickups or items on pedestals, allowing them to be picked up for free.

Unlock method: Complete Cursed (challenge #10)

???

Displays a cryptic statement on the screen, similar to a Fortune Teller. These messages (often) provide hints on bosses, bonus areas, etc.

Unlock method: Complete Glass Cannon (challenge #11)

Double active

When used, copies the effect of Isaac's currently held activated collectible.

Unlock method: Always available

Something stinks...

Covers the entire room with poop. The process is not instant, and the room will not get filled if you leave it before it's done filling.

Unlock method: Complete When Life Gives You Lemons (challenge #12)

Open Sesame

Upon use, opens all doors in the current room (including the golden door at The Chest / Dark Room), similar to Dad's Key.

Unlock method: Complete SPEED! (challenge #22)

You feel protected

Grants the Holy Mantle effect. It lasts for the current room. It lasts until taking damage.

Unlock method: Defeat Delirium as The Lost

Again

When used, copies the effect of the most recently used pill, card, rune, soul stone or activated item.

Unlock method: Defeat Mega Satan as Tainted Eden

Destruction

Destroys all breakable objects in the room. Does not affect Key Blocks. Does affect Key Blocks

Unlock method: Complete Pitch Black (challenge #1)

Abundance

Clones all pickups and chests in a room (including Shop pickups; the clones can then be picked up for free). Cloned chests will contain exactly the same type of items: if the original contains a pickup, so will the clone; the same is true for collectibles. Cannot clone other Jera runes and trinkets.

Unlock method: Complete High Brow (challenge #2)

Passage

Creates a trapdoor leading to the next floor. Has an estimated 1/12 (8%) chance to spawn a door to a Crawl Space instead.

Unlock method: Complete Head Trauma (challenge #3)

Purity

Removes any curses from the current floor and grants a Soul Heart. (This will not remove Curse of the Labyrinth.)

Unlock method: Complete Darkness Falls (challenge #4)

Vision

Reveals the whole map, including the Secret Room and the Super Secret Room. (This will not remove Curse of the Lost.)

Unlock method: Complete The Tank (challenge #5)

Change

Rerolls all pedestal items in the room. (This is the same effect as The D6.)

Unlock method: Complete Solar System (challenge #6)

Companionship

Summons 3 friendly Blue Flies and 3 friendly Blue Spiders.

Unlock method: Complete Purist (challenge #20)

Resistance

Grants a shield which lasts for 30 seconds. Grants a shield which lasts for 20 seconds.

Unlock method: Complete Cat Got Your Tongue (challenge #8)

???

Grants a random rune effect excluding the Black Rune. Has a 25% chance to spawn another Blank Rune upon use.

Unlock method: Complete Onan's Streak (challenge #29) Complete The Guardian (challenge #30)

Void

Deals 40 damage to all enemies in the room. Consumes all pickups in the room and turns them into Blue Flies and Spiders. Consumes all pedestal items in the room and turns them into random stat upgrades. No effect on shop items.

Unlock method: Defeat Ultra Greedier as Apollyon

It still glows faintly

Activates a random, weak rune effect: Algiz grants a 3 second shield, Ansuz reveals the map up to 3 rooms away, Berkano gives 1 blue fly and spider, Dagaz gives half a soul heart, Ehwaz makes a trapdoor, Hagalaz destroys some rocks, Jera duplicates one pickup and Perthro rerolls one item.

Unlock method: Always available

Reroll... or not

Rerolls the items in the room like The D6, but they cycle back to their original form after one second, repeating. If more uses are stacked, an additional item per use will be cycled through.

Unlock method: Defeat Hush and Boss Rush as Tainted Isaac

Give me your love!

Surrounds Isaac with a bubbling red aura for the current room. All enemies killed drop red half hearts that disappear in 2 seconds.

Unlock method: Defeat Hush and Boss Rush as Tainted Magdalene

Opens the unopenable

Invokes Dad's Key, opening all existing doors in the room. Additionally, creates a red room like the Red Key for every possible red exit.

Unlock method: Defeat Hush and Boss Rush as Tainted Cain

Right behind you

Stops time for 3 seconds and invokes Dark Arts, turning Isaac into a phantom that can pass through enemies to paralyze them, then attack them for quickly increasing chained damage and damage bonuses.

Unlock method: Defeat Hush and Boss Rush as Tainted Judas

Chemical warfare

Causes 8 poison farts that leave lingering brown creep, then plants a trail of 7 Butt Bombs in quick succession. Standing on the creep gives +1.35 tears and +1 damage.

Unlock method: Defeat Hush and Boss Rush as Tainted ???

Your very own murder

14 Dead Bird familiars fly in and attack enemies. They leave after all victims are dead or Isaac leaves the room.

Unlock method: Defeat Hush and Boss Rush as Tainted Eve

Slay a thousand

Isaac turns into a berserk Tainted Samson for 10 seconds, gaining +0.4 speed, some tears and +3 flat damage along with his melee attack.

Unlock method: Defeat Hush and Boss Rush as Tainted Samson

Demon rage!

Activates Mega Blast for 7.5 seconds.

Unlock method: Defeat Hush and Boss Rush as Tainted Azazel

Life after death

Isaac dies, and is immediately revived at half a heart remaining in the same room, with some invincibility time. The soul stone is automatically used upon taking fatal damage, as well, functioning as a minimal extra life.

Unlock method: Defeat Hush and Boss Rush as Tainted Lazarus

Embrace chaos

Uses The D6 and D20. The rerolled items use random pools, as if Chaos were active.

Unlock method: Defeat Hush and Boss Rush as Tainted Eden

Leave your body behind

Isaac "dies" and turns into The Lost for the current room, with all The Lost's benefits and weaknesses. He returns to normal upon leaving the room.

Unlock method: Defeat Hush and Boss Rush as Tainted Lost

Motherhood

Adds one permanent familiar from the Baby Shop pool, except Stitches. Unique familiars can be received only once.

Unlock method: Defeat Hush and Boss Rush as Tainted Lilith

$$$

Spawns ~2-25 random coins.

Unlock method: Defeat Hush and Boss Rush as Tainted Keeper

Bringer of calamity

Spawns 15 random locusts.

Unlock method: Defeat Hush and Boss Rush as Tainted Apollyon

Skeletal protector

Spawns The Forgotten as a temporary secondary character, controlled at the same time as Isaac. He dies if his two bone hearts run out, with no further consequence, and disappears when Isaac leaves the room.

Unlock method: Defeat Hush and Boss Rush as Tainted Forgotten

Friends from beyond

Spawns 6 Book of Virtues wisps with random properties.

Unlock method: Defeat Hush and Boss Rush as Tainted Bethany

Bound by blood

Spawns Esau as a temporary secondary character, controlled at the same time as Isaac. He dies if his health runs out, with no further consequence, and disappears when Isaac leaves the room.

Unlock method: Defeat Hush and Boss Rush as Tainted Jacob

D6 + D20

Upon use, activates the effects of The D6 and the D20 at the same time.

Unlock method: Always available

Help from above

When used, will cause two Mom's Hands to come down and grab two random enemies.

Unlock method: Always available

???

Creates a room adjacent to a viable wall, like Red Key.

Unlock method: Open the large version of Mom's Box in Home