Imaginary Friend

Spawns a familiar that floats slowly around the room on a pattern similar to The Peeper and fires spectral and homing tears.

It glows with power

5% chance to induce The Necronomicon's effect upon taking damage.

Trickle charge

Automatically recharges the last energy slot of an activated item, effectively reducing recharge rates by one.

Luck of the draw

Increases the chance of tarot cards or playing cards dropping after clearing a room, and the chance of finding cards when opening a chest.

Faith up

Increases chance for Eternal Hearts to spawn.

Evil Up

Increases the chance of Black Hearts appearing.

Wealth of health

Gives a chance to drop a Half Red Heart when a coin is collected.

Eternal life?

When held, Isaac has a chance to be revived as ???. Can occur multiple times in the same run.

It kinda works!

Pulls coins towards Isaac, but ignores other pickups.

It's broken

Triggers the Teleport effect whenever an activated item is used.

Wealth of chaos

Gives a chance to drop a bomb when a coin is collected.

Wealth of gas

Isaac will fart when he picks up a coin. Coins have a higher chance to drop from poop.

May you see your destination

When starting a floor, 25% chance to get the The Compass effect for the duration of a floor.

Your feet feel stronger

Prevents damage from creep and spikes.

Yay, cancer!

-2 tear delay (effectively increases firerate of tears).

I remember these

Chance to trigger The Gamekid effect upon taking damage.

It calls out to its brothers.

Increases the chance of a heart pickup dropping after clearing a room, and the chance of finding a heart when opening a Chest.

Wealth of wealth

Gives a 50% chance of increasing the value of every coin pickup by one.

Cursed?

If Isaac has less than one full Red Heart after taking damage, he will be immediately teleported to the last cleared room he was in.

DMG up

Increases damage by 2.

Evil up

Most non-specific heart drops become Black Hearts, but heart drops are significantly less common.

Revenge from beyond

5% chance to spawn a Dead Bird familiar for the current room each time an enemy dies.

It stinks

Spawns a Blue Fly every time Isaac takes damage.

Wealth of answers

Gives a chance to drop a key when a coin is collected.

Blub blub!

Isaac's tears take on an oblong appearance. They also push enemies back.

Speed up

Increases speed by 0.15.

Zip zoop!

Tears move shifting left to right forming a path of right angles. +10 to range (effective range remains about the same).

Consume thy enemy

Isaac has a chance to heal for 1/2 a Red Heart upon clearing a room.

Dead friend

Spawns Isaac's severed head as a tear-firing familiar. Fires piercing tears.

Payment Received

Items in the Devil Room only cost 1 heart. Soul heart trades still cost 3 soul hearts.

Touch Fuzzy, Get Dizzy

Grants a chance of triggering Mini Mush, Odd Mushroom (Large), Odd Mushroom (Thin) or The Compass effects for the current room upon entering it.

There's something inside it

Rocks and their variants drop 1 penny when destroyed.

Luck up!

+1 Luck. Adds a chance to drop an extra pickup when opening a chest, destroying a machine, or blowing up a tinted rock.

Faith's reward

Gives an eternal heart at the start of every floor.

Tastes like burning

Increases the chance of Bombs dropping after clearing a room, and the chance of finding Bombs when opening a Chest.

???

If Isaac dies in a Sacrifice Room, a puzzle piece will appear on his last will. Dying in Sacrifice Room while holding it unlocks The Lost. If The Lost is unlocked, revives Isaac as The Lost on death then disappears.

It emanates purity

Grants a secondary 10% chance of any non-specific heart drop turning into a soul heart.

???

Once a minute, Mom's foot randomly stomps down somewhere in the room.

Wish granted

If the character has half a heart after taking damage, it drops a black heart. The effect can trigger up to three times, after which the trinket will disappear.

Uh-oh!

Isaac farts or poops at random intervals. Getting hit can also trigger the effect.

???

Has a chance to replicate the effects of A Missing Page, The Polaroid, The Negative, or Missing Poster.

Master of lockpicking

Locked Chests can be opened without using a key.

It feels lucky?

Greatly increases the chances of a pickup dropping when destroying poop.

Poison shots

Adds a 10% chance to shoot a poison tear, dealing damage over time when inflicted.

Wub wub!

Tears pulsate in size as they travel.

Challenge up

Increases the chance of encountering champion enemies and bosses.

Piercing shots

Adds a 10% chance to shoot a piercing and spectral tear.

Your rage grows

Grants a chance of increasing damage by 1.8 for the current room upon taking damage.

Woop woop!

Isaac fires in a fast spiraling pattern. Also grants spectral tears.

Faith up

Increases the chance of Angel Rooms appearing, as well as the chance to find The Bible in the Library and Shop.

It feels lucky?

Increases the chance of keys dropping after clearing a room, and the chance of finding keys when opening a Chest.

Don't swallow it

Improves the chance of pills dropping after clearing a room, and the chance of finding a Pill when opening a Chest.

Your rage grows

1/15 chance to increase damage by 0.5 for the current room each time an enemy dies.

YES!

The next store purchase is free. The trinket disappears on purchase.

Gulp!

Upon taking damage, Isaac drops a penny.

The left-hand path reaps dark rewards

Replaces all types of chests with red chests.

Well, that's not coming off

Drains 15% health from enemies with more than 60 HP. Restores one Red Heart when entering an uncleared boss room. The Tick cannot be dropped or swapped for another trinket.

Fetal Protection

When brought down to only a Half Red Heart, spawns a Little Steven familiar for the current room. Adds a high chance to spawn a Gemini familiar for the current room after taking damage.

Wooosh!

Increases shot speed by 0.5, increasing effective range.

Wiggle waggle!

Gives Isaac's shots a wave-like trajectory. +0.4 tears.

With darkness comes power

Increases Isaac's damage for possessing certain evil items.

Pop! Pop!

Exploding bombs have a chance to drop another Bomb pickup.

Blind to damage

Increases invincibility time after getting hit.

Bounce back!

Increases knockback of tears.

Creepy bombs

Leaves a pool of green creep under all bombs Isaac places, which damages enemies that walk over it.

Fartoom!

Poop blocks will explode after being destroyed.

Keep your friends close...

Causes familiars to stay closer to each other.

You feel cursed... kinda.

Activates the effect of The D6, D8, D12, or D20 whenever Isaac takes damage.

I'm stuck in a loop...

Has a 25% chance of creating a duplicate of any pill, card, or rune Isaac uses.

Effect not found?

Gives a random trinket effect each room.

You feel faded

Occasionally causes Isaac to blend into the ground, which briefly confuses all enemies in the room.

Feel lucky?

+15% chance for Treasure Rooms to have two items. Only one item can be taken.

Karma up

Donating to a donation machine has a chance to heal Isaac for a full red heart or spawn a beggar. Increases the chance that donating to a Donation Machine will increase Isaac's luck.

Pft

Increases Range by 4 and decreases Shot Speed by .4.

The poop is moving...

Spawns a Blue Fly from every pile of poop that Isaac destroys.

Itchy, tasty...

Occasionally spawns a Blue Spider.

You feel her love

Grants half a red heart each time a key is used. Converts half red heart pickups into full red hearts.

Never again!

Prevents active items from being generated, if possible.

It's double down time!

Chests have a 50% chance of paying out with extra pickups and a 50% chance of paying out with nothing or enemies.

Bleep Bloop Blop

Isaac's tears gain a worm effect that changes every 3 seconds.

Feels greedy

Prevents Greed and Super Greed from appearing in shops and secret rooms, and makes coin drops after clearing rooms more likely.

Fuse Cutter

Troll bombs turn into Bomb pickups before they explode. Mega troll bombs turn into 1+1 free bombs before they explode.

Extended stat effect time!

Increases the time that status effects stay on enemies.

It shines for its brothers

Tinted rocks and rocks with crawl spaces flash white upon entering the room and every 10 seconds afterward.

Stores are open

Shops can be opened without using keys.

The ground below feels hollow...

Increases the chance to find a Crawl Space.

It Pulls

Pulls enemies and pickups towards Isaac.

Floooooooooop!

Doubles Isaac's range and halves his tear height.

Lil charge

Increased chance of batteries spawning. Has a chance to add an extra charge to Isaac's activated item upon completing a room.

Feed them magic!

Grants Isaac's familiars homing shots.

I wonder what it is

Taking damage has a small chance to destroy the trinket and spawn Lunch.

They are growing...

Upon killing an enemy, has a chance to grant flight for the rest of the room.

It looks dead

Adds a chance to fire a black tooth that deals double damage and poisons enemies.

Drips with blood...

Treasure Rooms appear in chapter 4.

Can't hold it!

Using an active item will drop it onto a pedestal on the ground. Taking damage may result in dropping a passive item.

Stat booster

Decreases Isaac's tear delay by 20%, and improves the effectiveness of his other stat upgrades by ~33%. Improves the effectiveness of other stat upgrades by ~20%.

Drain me

Red Heart damage will be taken before Soul Heart, Black Heart, and Rotten Heart damage.

I think it's broken

Provides a boost to all stats when Isaac's active item is completely uncharged.

Hold the door!

The last door Isaac went through stays open, allowing him to leave the room even if enemies are in it.

Stuck!

Holds Isaac's familiars in place relative to his position.

=

Turns pickups into their doubled versions while Isaac's numbers of coins, bombs, and keys are equal.

Charged friends

Beams of yellow electricity flow between Isaac and his familiars, damaging any enemies between them.

Angelic Spoils!

Angels drop Angel Room items instead of key pieces when defeated.

It looks brittle

Grants a chance to gain a bone heart upon taking damage.

It also stinks!

Items and trinkets that generate Blue Flies or locusts will generate twice as many.

Double moon

Makes two Secret Rooms spawn on each floor.

Danger charge

Fully recharges Isaac's active item upon entering a boss fight.

I bring Conquest

Upon entering a room with enemies, spawns 2-5 White Locusts which damage enemies.

I bring Death

Upon entering a room with enemies, spawns a Black Locust that does a very high amount of damage.

I bring Famine

Upon entering a room with enemies, spawns a Yellow Locust that damages and slows enemies.

I bring Pestilence

Upon entering a room with enemies, spawns a Green Locust which damages and poisons enemies.

I bring War

Upon entering a room with enemies, spawns a Red Locust which detonates upon impact with enemies.

Uncorked

Increases the radius of any creep produced by Isaac.

Eww

Black poop can drop black hearts when destroyed. Poop has a chance to turn into black poop.

Seems magic...

Chance to fire a homing booger that sticks to enemies and deals damage over time.

Foop foop!

Tears travel in a large spiral pattern and become spectral, with a small chance to home.

...

Restock boxes always spawn in Item Rooms.

Wealth of flies

Spawns a Blue Fly every time a coin is picked up.

Feels lucky...

Shops appear in Chapter 4.

Regen!

Heals Isaac for half a heart upon traveling to the next floor. Heals Isaac's Red Heart health to 50% of maximum upon traveling to the next floor. If his health is already equal to or above 50%, it heals half a Red Heart instead.

Boing!

Makes tears have a chance to bounce off enemies and obstacles.

Sick...

When hit, there is a small chance a removed tonsil familiar starts following Isaac, blocking enemy shots.

You stink

Grants the Skatole effect in some rooms.

It needs power

Provides a boost to all stats when Isaac's active item is fully charged.

That's a hard nut to crack!

Being hit by explosions will eventually destroy the trinket and spawn various pickups.

Make a wish

Taking damage has a small chance to destroy the trinket and spawn a random item.

My faith protects me

Grants a shield that negates the first damage taken once per floor.

t's broken9Reroll your dest

Using an activated item rerolls it.

Watch the world burn

Adds a chance for enemies to burn upon entering a room.

Give them a home

Shops can sell familiars, which will always be at a discounted price.

Attack buddy

Spawns two attack locust familiars which will fly forward while Isaac shoots.

It feels empty

Picking up red hearts, even while at full health, can convert them into blue spiders. The effect may consume hearts needed for healing.

Unleash your inner demon

When clearing a room, adds a chance to turn into Azazel until clearing another.

Virtue's reward

Once per floor, taking damage will spawn a wisp and grants a few seconds of invulnerability. Entering an Angel Room spawns 5 wisps. Giving money to beggars can spawn wisps.

My faith protects me

At the beginning of each floor, spawn 4-8 wisps that orbit Isaac and fires tears alongside him.

Wealth of purity

Gives a chance to drop a Half Soul Heart when a coin is collected.

Look between the rooms

Doors can be unlocked without using keys. Opening a door this way brings Isaac to an in-between room that resembles ???, with a few monsters.

Ding!

Tears snap 90 degrees to target enemies that they may have missed.

Double vision?

Gives a 33% chance to add a '?' item to Treasure Rooms. Only one item can be taken. The extra items on the alt path are revealed instead.

Bombs are key

Locks can be opened with explosions.

Mystery medicine

Grants a chance to gain a random syringe effect for the current room.

Wealth of power

Picking up coins has a chance to give an Active Item charge.

It's leaking

Adds a chance to fire tears that slow enemies.

Infested

Adds a chance to spawn a random locust when killing an enemy.

Call to the other side

Adds a chance to automatically create Red Key rooms after clearing a room.

Wealth of misery

Picking up coins teleports Isaac to a random room.

His special customer

Treasure Rooms are replaced with unique Red Treasure Rooms, offering a Deal with the Devil in place of an item.

Bonus roll

When Isaac enters a new room, has a chance to give him a Dice item as a consumable for the current room.

Oops!

Spawns two friendly Dips upon clearing a room.

Fun extras

Using an active item triggers another random active item effect.

No more spikes

Causes all spikes to retract, making them harmless. Also affects the doors to Curse Rooms.

Sing for your friends

Improves the fire rate of Isaac's familiars.

Finally!

Spawns a familiar that copies Isaac's movements and scales with damage and tears. If it takes damage, it will die and respawn on the next floor.

Gather round

Causes familiars to orbit Isaac.

Mega farts

Increases the size of Isaac's farts.

Less is more

Replaces all new chests, except Mega Chests, with Locked Chests.

A brittle blessing

Grants an empty bone heart upon entering a new floor.

Walk the path of the saint

A Treasure Room and Shop appears in the Cathedral.

Stay frosty

Adds a chance to petrify enemies when entering the room. Killing the petrified enemy freezes it.

Don't chew on it

Adds the chance to fire teeth that deal 3.2x damage, similar to Tough Love.

Money talks

Devil Deals cost money instead of health.

Looks familiar...

While held, counts towards the Guppy transformation.

Mini friend

Spawns a clot familiar that mimics Isaac's movements and tears. It dies for the current room after taking too much damage.

Free goodies!

Spawns a Grab Bag upon traveling to the next floor.

???

Grants the effect of a random passive Item each room.

A piece of her love

Grants the effects of a random Mom item each room.

HP up

Grants one heart container.

Forget me not...

When entering a new floor, up to four uncollected pickups from the previous floor spawn in the starting room.

Don't want!

Replaces keys and coins that spawn in Chapter 4 and beyond with more useful pickups.

6

Increases the chance of earning a Devil Room by 10%.

Voltage starving

Active items don't charge when clearing rooms. Adds a chance to spawn a Lil' Battery when clearing a room, independent of the room's original drop.

Push in case of emergency

Activates Isaac's active item just before he takes damage.

Luck way up. Don't lose it!

+10 Luck. If Isaac takes damage, the trinket is destroyed and its effect is removed.

Friends from beyond

After clearing a room, adds a chance to spawn a friendly Bony.

Controllable buddies!

Instead of trailing behind Isaac, familiars are directly controlled by the same inputs as Isaac's.

Twice the bang!

Spawns one extra bomb for each bomb placed for free.

Faster explosions

Bombs placed by Isaac explode more quickly.

Revel in death

Grants an invulnerability shield for 1 second after killing an enemy.

What could it open?

Unlocks the passageway to ??? and the Hush fight, regardless of the run duration. Using Pandora's Box grants it a special effect, consuming the key.

Bang!

Isaac explodes upon taking damage.

It feels lucky

Luck-based tear effects have a higher chance of occurring.

Seek the stars

Increases the chance for Planetariums to spawn, adds a chance for a second Planetarium to spawn, and allows Planetariums to spawn in Chapter 4.

You feel braver

Spawns a chest after clearing a mob Challenge Room, or an item after clearing a boss Challenge Room.

I'm seeing double...

Adds a chance to duplicate one of Isaac's familiars when entering a new room.

Death awaits

Adds a chance to shoot an Ipecac + My Reflection tear.

A hole in your pocket

Upon taking damage, Isaac drops 2 random Pickups from his inventory.

Walk the path of the wicked

A Treasure Room and Shop appears in Sheol.

Give it to me

Can be used to pay for a Devil deal without losing hearts, and is then consumed.