Item Guides
The best and most powerful items in The Binding of Isaac: Rebirth, grouped by type.
Passive Items (10)
Brimstone
Replaces tears with a powerful blood laser beam that charges and fires across the entire room. One of the strongest damage items in the game.
Ipecac
Tears become explosive, arcing shots that deal massive damage on impact. Adds 40 flat damage but can hurt the player with self-splash.
Tech X
Tears are replaced with chargeable laser rings that travel across the room. Damage scales with charge time and synergizes with most tear effects.
Sacred Heart
Grants homing tears, a huge damage multiplier, increased health, and slower shot speed. One of the rarest and most powerful items.
Mom's Knife
Replaces tears with a throwable knife that deals massive damage based on charge. Short range but extremely high DPS at close range.
Polyphemus
Massively increases damage at the cost of fire rate. Tears that kill an enemy continue traveling with leftover damage. Giant tear effect.
Crown of Light
Doubles damage while the player has no empty red heart containers. Deactivates upon taking damage but reactivates after clearing a room.
Dead Cat
Grants 9 extra lives but sets health to one red heart container. Part of the Guppy transformation which grants flight and spawns attack flies.
Guppy's Paw
Converts one red heart container into three soul hearts on use. Part of the Guppy transformation. Excellent for trading health for survivability.
Spirit Sword
Replaces tears with a melee sword that deals high damage and can fire projectile slashes at full health. Spin attacks deal extra damage.
Active Items (8)
Mega Blast
Fires an enormous Brimstone laser for the entire room duration and persists across rooms. The rarest and most powerful active item in the game.
Book of Revelations
Grants one soul heart on use and guarantees a Horseman boss on the current floor, dropping a cube of meat or ball of bandages.
The Bible
Grants flight for the current room. Instantly kills Mom and Mom's Heart bosses but also instantly kills the player against Satan.
Box of Friends
Doubles all familiars for the current room. Essential for Lilith and extremely powerful with multiple familiar items.
Crooked Penny
Has a 50% chance to double all pickups and items in the room, or a 50% chance to destroy them all. High risk, high reward.
D6
Rerolls item pedestals into different items. Isaac's signature item and one of the most consistently useful active items in the game.
Void
Absorbs passive items to gain stat boosts and absorbs active items to trigger their effects on each Void use. Apollyon's starting item.
Death Certificate
Teleports the player to a special floor containing every item in the game. Choose any single item for free. Single use only.