Cards and Runes

Pickups

• Hearts
• Coins
• Bombs
• Keys
• Batteries
• Pills
• Cards/Runes
• Chests
• Sacks

Cards and runes are single-use pickups with a wide variety of effects. They take up the same slot as pills.

Runes and special cards are unlocked by completing challenges.

In the base game, there are 32 cards and 8 runes.

• The Binding of Isaac: Afterbirth adds Get out of Jail Free Card, ? Card, the Blank Rune and two non-card consumables: Dice Shard and Emergency Contact.

• The Binding of Isaac: Afterbirth † adds the Ace cards, Holy Card and Black Rune, for a total of 39 cards and 10 runes.
  • Booster Pack #1 also added three other Magic: The Gathering cards: Huge Growth, Ancient Recall and Era Walk.

• The Binding of Isaac: Repentance adds Reversed Major Arcana Cards, the Queen of Hearts, the Wild Card, Rune Shards, Soul Stones as well as the Cracked Key, for a grand total of 66 cards, 28 runes and 3 other consumables.

• The Binding of Isaac: Repentance+ does not add any card or rune.

Cards

Major Arcana Cards

When on the ground, these cards look like:

Name	ID	Icon	Message	Description
0 - The Fool	5.300.1		Where journey begins	Teleports Isaac to the starting room of the current floor.
I - The Magician	5.300.2		May you never miss your goal	Grants homing tears for the current room. Grants homing tears and +3 Range for the current room.
II - The High Priestess	5.300.3		Mother is watching you	Mom's dismembered leg stomps on the enemy with the most health, dealing 300 damage and destroying obstacles in the area. If used in an empty room or during the Mom fight, stomps Isaac instead. Isaac can move to avoid the stomp.
III - The Empress	5.300.4		May your rage bring power	Triggers the Whore of Babylon effect (+1.5 Damage, +0.3 Speed) for the current room, regardless of Isaac's total health.
IV - The Emperor	5.300.5		Challenge me!	Teleports Isaac into the Boss Room.
V - The Hierophant	5.300.6		Two prayers for the lost	Spawns 2 Soul Hearts on the ground.
VI - The Lovers	5.300.7		May you prosper and be in good health	Spawns 2 full Red Hearts on the ground.
VII - The Chariot	5.300.8		May nothing stand before you	Gives invulnerability and +0.28 speed for six seconds, removing the ability to shoot tears and replacing it with the ability to deal contact damage to enemies.
VIII - Justice	5.300.9		May your future become balanced	Drops a random type of Heart, Key, Bomb, and Coin pickup on the ground.
IX - The Hermit	5.300.10		May you see what life has to offer	Teleports Isaac to the Shop.
X - Wheel of Fortune	5.300.11		Spin the wheel of destiny	Spawns a Slot Machine or Fortune Telling Machine near Isaac.
XI - Strength	5.300.12		May your power bring rage	Grants the effects of Magic Mushroom (minus the health restoration) for one room. The added Red Heart container is not removed if doing so would kill Isaac.
XII - The Hanged Man	5.300.13		May you find enlightenment	Grants flight for the duration of the room.
XIII - Death	5.300.14		Lay waste to all that oppose you	Triggers The Necronomicon effect, dealing 40 damage to all enemies in the room.
XIV - Temperance	5.300.15		May you be pure in heart	Creates a Blood Donation Machine near Isaac. Spawns a Devil Beggar instead in Greed mode.
XV - The Devil	5.300.16		Revel in the power of darkness	Triggers The Book of Belial effect, granting +2 Damage for the current room.
XVI - The Tower	5.300.17		Destruction brings creation	Spawns 6 Troll Bombs randomly around the room.
XVII - The Stars	5.300.18		May you find what you desire	Teleports Isaac to the Treasure Room. If there is a Planetarium, teleports Isaac there instead.
XVIII - The Moon	5.300.19		May you find all you have lost	Teleports Isaac to the Secret Room.
XIX - The Sun	5.300.20		May the light heal and enlighten you	Restores Isaac to full health, deals 100 damage to all enemies in the room, and reveals the map for the current floor, except for the Super Secret Room and Ultra Secret Room. Removes Curse of Darkness for the current floor.
XX - Judgement	5.300.21		Judge lest ye be judged	Spawns a Beggar near Isaac. The beggar can sometimes be a Devil Beggar and rarely a Battery Bum, Rotten Beggar, Key Master, or Bomb Bum instead.
XXI - The World	5.300.22		Open your eyes and see	Reveals the entire floor, except for the Super Secret Room and Ultra Secret Room.

Reversed Major Arcana Cards

These cards share the same names as their counterparts (barring the question marks at the end of their names), but have the sprite upside-down, a different message, the narrator sound clip reversed, and give different effects.

When on the ground, these cards look like:

Name	ID	Icon	Unlock method	Message	Description
0 - The Fool?	5.300.56		Defeat Ultra Greedier as Tainted Lost	Let go and move on	Drops all hearts, trinkets, and pickups Isaac currently possesses on the floor, leaving Isaac at half a heart. Pickups may be dropped as items such as A Quarter and Boom!.
I - The Magician?	5.300.57		Defeat Ultra Greedier as Tainted Judas	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.
II - The High Priestess?	5.300.58		Defeat Ultra Greedier as Tainted Lilith	Run	Mom's leg starts stomping down repeatedly (targeting Isaac, not enemies) for one minute, like holding Broken Shovel.
III - The Empress?	5.300.59		Defeat Ultra Greedier as Tainted Eve	May your love bring protection	Grants 2 temporary Red Heart Containers, +1.5 Fire Rate, and -0.1 Speed for one minute, along with Magdalene's hairstyle. The effect does not stack with itself. When the effect ends, if the removal of the Heart Containers would kill Isaac, he is left with one instead.
IV - The Emperor?	5.300.60		Defeat Ultra Greedier as Tainted ???	May you find a worthy opponent	Teleports Isaac into an extra Boss Room from the boss pool two floors deeper than the current floor (but never a final boss). The boss will drop a reward. Exiting the room returns Isaac to where he used the card.
V - The Hierophant?	5.300.61		Defeat Ultra Greedier as Tainted Bethany	Two prayers for the forgotten	Spawns 2 Bone Hearts on the ground.
VI - The Lovers?	5.300.62		Defeat Ultra Greedier as Tainted Magdalene	May your heart shatter to pieces	Creates a random item from the current room's item pool. Turns one Red Heart Container or two Soul Hearts into a Broken Heart.
VII - The Chariot?	5.300.63		Complete Hot Potato (challenge #42)	May nothing walk past you	Isaac becomes an invincible statue with 4× fire rate for 10 seconds. The statue can be nudged slightly by moving and is affected by knockback.
VIII - Justice?	5.300.64		Complete Cantripped (challenge #43)	May your sins come back to torment you	Creates 2 to 4 Locked Chests near Isaac.
IX - The Hermit?	5.300.65		Complete Red Redemption (challenge #44)	May you see the value of all things in life	Turns items and pickups in the room into Coins, matching their normal shop price. If there is nothing to sell, drops a Penny.
X - Wheel of Fortune?	5.300.66		Defeat Ultra Greedier as Tainted Cain	Throw the dice of fate	Invokes a random Dice Room effect.
XI - Strength?	5.300.67		Defeat Ultra Greedier as Tainted Samson	May you break their resolve	All enemies in the room are weakened, becoming slow and taking double damage. The effect lasts up to one minute or until the room is left.
XII - The Hanged Man?	5.300.68		Defeat Ultra Greedier as Tainted Keeper	May your greed know no bounds	Isaac turns visually into Keeper for 30 seconds, with triple shot and -0.1 Speed. Killed enemies drop random Coins.
XIII - Death?	5.300.69		Defeat Ultra Greedier as Tainted Forgotten	May life spring forth from the fallen	Creates a friendly Bony or temporary bone orbital for each enemy killed in the current room.
XIV - Temperance?	5.300.70		Complete DELETE THIS (challenge #45)	May your hunger be satiated	Forces Isaac to eat 5 random Pills in quick succession. Eaten pill types become identified.
XV - The Devil?	5.300.71		Defeat Ultra Greedier as Tainted Azazel	Bask in the light of your mercy	Invokes The Bible (which can kill Mom). Grants Flight and spawns a Seraphim familiar for 30 seconds.
XVI - The Tower?	5.300.72		Defeat Ultra Greedier as Tainted Apollyon	Creation brings destruction	Creates 7 clusters of random rocks and other obstacles. Spawned clusters will often contain tinted rocks, with the possibility of finding more than one in the same room. The pathways between exits can't be blocked.
XVII - The Stars?	5.300.73		Defeat Ultra Greedier as Tainted Isaac	May your loss bring fortune	Removes Isaac's oldest passive item (ignoring starting items) and creates 2 random item pedestals from the current room's item pool. Does nothing if Isaac has no items.
XVIII - The Moon?	5.300.74		Defeat Ultra Greedier as Tainted Jacob	May you remember lost memories	Teleports Isaac to the Ultra Secret Room. The pathway back to the normal rooms will be made of Red Rooms.
XIX - The Sun?	5.300.75		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 floor. Turns Isaac's Red Hearts into Bone Hearts, but they revert once the effect ends. Also causes Curse of Darkness that cannot be dispelled.
XX - Judgement?	5.300.76		Defeat Ultra Greedier as Tainted Lazarus	May you redeem those found wanting	Spawns a Shop Restock Machine near Isaac.
XXI - The World?	5.300.77		Defeat Ultra Greedier as Tainted Eden	Step into the abyss	Creates a trap door which always leads to a Crawl Space.

Playing Cards

When on the ground, these cards look like:

Name	ID	Icon	Unlock method	Message	Description
2 of Clubs	5.300.23		Always available	Item multiplier	Doubles Isaac's Bombs. If he has no bombs, gives him 2 instead.
2 of Diamonds	5.300.24		Always available	Item multiplier	Doubles Isaac's Coins. If he has no coins, gives him 2 instead.
2 of Spades	5.300.25		Always available	Item multiplier	Doubles Isaac's Keys. If he has no keys, gives him 2 instead.
2 of Hearts	5.300.26		Always available	Item multiplier	Doubles Isaac's current number of Red Hearts. Doesn't add new Red Heart containers, just fills empty ones. If Isaac has only empty Red Heart containers, he is healed for 1 Red Heart. Doubles Tainted Bethany's Blood Charges.
Ace of Clubs	5.300.27		Get a 3-win streak	Convert all	Turns all pickups, chests, and non-boss enemies in the room into random bomb pickups, including Troll Bombs.
Ace of Diamonds	5.300.28		Defeat The Lamb in under 20 minutes	Convert all	Turns all pickups, chests, and non-boss enemies in the room into random coin pickups.
Ace of Spades	5.300.29		Defeat The Lamb without taking Hearts, Coins, or Bombs through the entire run. Letting certain familiars (e.g. Bum Friend, Dark Bum, Bumbo or Lil Portal) or bosses (e.g. Bumbino) pick up the consumables fails this condition as well.	Convert all	Turns all pickups, chests, and non-boss enemies in the room into random key pickups.
Ace of Hearts	5.300.30		Complete a Chapter (floors I and II) after Basement, start-to-finish, with only half a Heart total (can use The Lost)	Convert all	Turns all pickups, chests, and non-boss enemies in the room into random hearts.
Joker	5.300.31		Always available	???	Teleports Isaac to the Devil Room or Angel Room.
Suicide King	5.300.46		Complete Suicide King (challenge #7)	A true ending?	Kills Isaac and spawns lots of Pickups, items, and/or Chests in the same room.
Queen of Hearts	5.300.79		Defeat Mega Satan as Tainted Magdalene	<3	Drops 1-20 full Red Hearts on the ground.

Magic: The Gathering Cards

When on the ground, these cards look like:   

Name	ID	Icon	Unlock method	Message	Description
Chaos Card	5.300.42		Complete Demo Man (challenge #9)	???	Throws the card in the direction Isaac is moving, which opens doors, breaks obstacles, and instantly kills any enemy in its path.
Huge Growth	5.300.52		Increase in size 5 times in a single run via Magic Mushroom, "One makes you larger" pills, XI - Strength, etc.	Become immense!	For the current room, makes Isaac larger, allows him to crush obstacles he walks on, and grants +7 flat Damage and +30 Range. For the current room, makes Isaac larger, allows him to crush obstacles he walks on, and grants +7 flat Damage and +3 Range.
Ancient Recall	5.300.53		Use Cards and Runes 20 times	Draw 3 cards	Spawns 3 random cards.
Era Walk	5.300.54		Add both the Broken Watch and the Stop Watch to your collection	Savor the moment	For the current room, enemies are slowed, Isaac's speed is increased by 0.50, and his shot speed is decreased by 1.00.

Credit Card

When on the ground, this card looks like:   

Name	ID	Icon	Unlock method	Message	Description
Credit Card	5.300.43		Complete Cursed! (challenge #10)	Charge it!	Makes all pickups and items that cost money or health in the room free.

Other Playing Cards

When on the ground, these cards look like:

Name	ID	Icon	Unlock method	Message	Description
Rules Card	5.300.44		Complete Glass Cannon (challenge #11)	???	Displays a cryptic statement on the screen, similar to a Fortune Telling Machine. These messages (often) provide hints on bosses, bonus areas, etc.
? Card	5.300.48		Always available	Double active	When used, copies the effect of Isaac's currently held activated collectible.

Card Against Humanity

When on the ground, this card looks like:   

Name	ID	Icon	Unlock method	Message	Description
A Card Against Humanity	5.300.45		Complete When Life Gives You Lemons (challenge #12)	Something stinks...	Covers the entire room with Poop. The process is not instant, and the room will not get filled if Isaac leaves before it's done filling.

Monopoly Card

When on the ground, this card looks like:   

Name	ID	Icon	Unlock method	Message	Description
Get out of Jail Free Card	5.300.47		Complete SPEED! (challenge #22)	Open Sesame	Upon use, opens all doors in the current room, exactly like Dad's Key.

Holy Card

When on the ground, this card looks like:

Name	ID	Icon	Unlock method	Message	Description
Holy Card	5.300.51		Defeat Delirium as The Lost	You feel protected	Grants a shield that blocks the next hostile damage that would be taken in the current room. Has a chance to spawn another Holy Card on use. Grants a shield that blocks the next hostile damage that would be taken.

Uno Card

When on the ground, this card looks like:

Name	ID	Icon	Unlock method	Message	Description
Wild Card	5.300.80		Defeat Mega Satan as Tainted Eden	Again	Copies the effect of the most recently used Pill, Card, Rune, Soul Stone, or activated item.

Runes

Left Pointing Runes

When on the ground, these runes look like:

Name	ID	Icon	Unlock method	Message	Description
Hagalaz	5.300.32		Complete Pitch Black (challenge #1)	Destruction	Destroys all breakable obstacles in the room. Does not affect Key Blocks.
Jera	5.300.33		Complete High Brow (challenge #2)	Abundance	Clones all pickups and chests in the 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.
Ehwaz	5.300.34		Complete Head Trauma (challenge #3)	Passage	Creates a trapdoor leading to the next floor. Has an estimated 1/12 (8%) chance to create a trapdoor leading to a Crawl Space instead. Guaranteed to create a trap door to a Crawl Space if used on floor tiles containing certain patterns. Will not create trapdoors if used on the end floor of a challenge.
Dagaz	5.300.35		Complete Darkness Falls (challenge #4)	Purity	Removes any Curses from the current floor and grants a Soul Heart. (This will not remove Curse of the Labyrinth.)

Right Pointing Runes

When on the ground, these runes look like:

Name	ID	Icon	Unlock method	Message	Description
Ansuz	5.300.36		Complete The Tank (challenge #5)	Vision	Reveals the whole map, including the Secret Room and the Super Secret Room. (This will not remove Curse of the Lost.) Does not reveal the Ultra Secret Room
Perthro	5.300.37		Complete Solar System (challenge #6)	Change	Rerolls all item pedestals in the room (the same effect as The D6).
Berkano	5.300.38		Complete Purist (challenge #20)	Companionship	Spawns 3 friendly Blue Flies and 3 friendly Blue Spiders.
Algiz	5.300.39		Complete Cat Got Your Tongue (challenge #8)	Resistance	Grants a shield which lasts for 30 seconds. Grants a shield which lasts for 20 seconds.
Blank Rune	5.300.40		Complete Onan's Streak (challenge #29) Complete The Guardian (challenge #30)	???	Grants a random rune effect excluding Black Rune. Has a 25% chance to drop another Blank Rune on the ground upon use.

Other Runes

Name	ID	Icon	Unlock method	Message	Description
Black Rune	5.300.41		Defeat Ultra Greedier as Apollyon	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.
Rune Shard	5.300.55		Always available	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 (including Ultra Secret Room), 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.

Soul Stones

Soul Stones are all unlocked by beating both Hush and Boss Rush as their respective tainted character. They count as runes for the purposes of Clear Rune and Rune Bag and can spawn anywhere a rune can.

Name	ID	Icon	Unlock method	Message	Description
Soul of Isaac	5.300.81		Defeat Hush and Boss Rush as Tainted Isaac	Reroll... or not	Rerolls all items in the room, 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.
Soul of Magdalene	5.300.82		Defeat Hush and Boss Rush as Tainted Magdalene	Give me your love!	Surrounds Isaac with a bubbling red aura for the current room. All enemies killed drop Half Red Hearts that disappear in 2 seconds.
Soul of Cain	5.300.83		Defeat Hush and Boss Rush as Tainted Cain	Opens the unopenable	Opens all doors in the room and creates a Red Room on all valid walls. This also destroys the mirror located in Downpour / Dross II.
Soul of Judas	5.300.84		Defeat Hush and Boss Rush as Tainted Judas	Right behind you	Increases Isaac's speed and makes him invulnerable for 3 seconds and allows him to pass through enemies. Damages all enemies and destroys all projectiles Isaac ran through when the effect ends, and grants a temporary Damage bonus for each enemy and projectile hit.
Soul of ???	5.300.85		Defeat Hush and Boss Rush as Tainted ???	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 +1.5 Fire Rate and +1 Damage.
Soul of Eve	5.300.86		Defeat Hush and Boss Rush as Tainted Eve	Your very own murder	14 Dead Bird familiars fly in and attack enemies. They leave after all enemies are dead or Isaac leaves the room.
Soul of Samson	5.300.87		Defeat Hush and Boss Rush as Tainted Samson	Slay a thousand	Isaac turns berserk for 10 seconds, replacing his tears with a melee bone club and gaining +0.4 Speed, some Tears, and +3 flat Damage.
Soul of Azazel	5.300.88		Defeat Hush and Boss Rush as Tainted Azazel	Demon rage!	Activates Mega Blast for 7.5 seconds.
Soul of Lazarus	5.300.89		Defeat Hush and Boss Rush as Tainted Lazarus	Life after death	Isaac dies, and is immediately revived at half a Heart in the same room, with some invincibility time. The soul stone is automatically used upon taking fatal damage. Has the highest priority of all Revival items.
Soul of Eden	5.300.90		Defeat Hush and Boss Rush as Tainted Eden	Embrace chaos	Rerolls all pickups and items in the room. The rerolled items use random pools, as if Chaos were held.
Soul of the Lost	5.300.91		Defeat Hush and Boss Rush as Tainted Lost	Leave your body behind	Isaac "dies" and turns into a ghost for the current room, with all of The Lost's benefits and weaknesses. The Holy Mantle effect gained from this can be stacked with multiple uses.
Soul of Lilith	5.300.92		Defeat Hush and Boss Rush as Tainted Lilith	Motherhood	Adds one permanent familiar from the Baby Shop pool, except Stitches. Can give familiars that Isaac already has. Unique familiars can be received only once.
Soul of the Keeper	5.300.93		Defeat Hush and Boss Rush as Tainted Keeper	$$$	Drops 1-25 random Coins on the ground.
Soul of Apollyon	5.300.94		Defeat Hush and Boss Rush as Tainted Apollyon	Bringer of calamity	Spawns 15 random locusts.
Soul of the Forgotten	5.300.95		Defeat Hush and Boss Rush as Tainted Forgotten	Skeletal protector	Spawns The Forgotten as a temporary secondary character, controlled at the same time as Isaac. He dies with no consequences if his health run out, and disappears when Isaac leaves the room. The bone swing deals high damage, and reflects tears.
Soul of Bethany	5.300.96		Defeat Hush and Boss Rush as Tainted Bethany	Friends from beyond	Spawns 6 Book of Virtues wisps with random properties.
Soul of Jacob and Esau	5.300.97		Defeat Hush and Boss Rush as Tainted Jacob	Bound by blood	Spawns Esau as a temporary secondary character, controlled at the same time as Isaac. He dies with no consequences if his health runs out, and disappears when Isaac leaves the room. Esau has random items equal to the number of items Isaac has, each based on the pools of the items Isaac's were obtained from.

Other

These are items other than cards and runes (and pills) that take up the consumable slot. When on the ground, each of these items are uniquely identifiable by their respective icon. These consumables cannot be replicated by either Blank Card or Clear Rune, and Tarot Cloth has no effect on them, but the D1 will always duplicate these into themselves.

Name	ID	Icon	Unlock method	Message	Description
Dice Shard	5.300.49		Always available	D6 + D20	Upon use, invokes the effects of The D6 and the D20 at the same time, re-rolling all item pedestals and pickups in the room.
Emergency Contact	5.300.50		Always available	Help from above	When used, will cause two Mom's Hands to come down and grab two random enemies, dealing damage and, if they have 40 or more HP, pinning them to the ground temporarily.
Cracked Key	5.300.78		Open Mom's Chest in Home	???	Creates a room adjacent to a viable wall, like Red Key.

Probabilities

Cards that spawn as random ones, i.e. with a sub-type of 0, have the following probabilities:

• Any tarot card (1-22) - 66.66%
  • A specific tarot card - 3.03%
• Any reverse tarot card (56-77) - 11.22%
  • A specific reverse tarot card - 0.51%
• Any face card (23-31) - 7.74%
  • A specific face card (23-31) - 0.86%
• Queen of Hearts (79) - 0.86% (same as a specific face card)
• Any special card (42-54) - 3.51%
  • A specific special card - 0.27%
• Cracked Key (78) - 0.27% (same as a specific special card)
• Wild Card (80) - 0.27% (same as a specific special card)
• Any rune (32-41) - 3.60%
  • A specific rune - 0.36%
• Any soul stone (81-97) - 5.95%
  • A specific soul stone - 0.35%
• Rune shard (55) - 0.00% (never spawns on a fully completed save file, chosen only as a replacement otherwise)

Notes

• The game counts runes as cards for the purposes of Blank Card, and Tarot Cloth.
  • Even though runes no longer count as cards as of Repentance, Little Baggy still prevents new runes from appearing except through forced drops (such as from Mom's Ring or Clear Rune). Runes that already existed prior to picking up Little Baggy will not be converted.
  • Starter Deck does not prevent runes/soul stones from generating, will sometimes turn pills into either, and allows holding two of them.
  • It also does not increase the chance of a Devil Room or Angel Room appearing when used like with the Book of Belial.
  • III - The Empress? also works this way.
• Runes will be replaced with cards if no runes are unlocked.
  • However, items that normally spawn runes (e.g. Rune Bag or Clear Rune) can spawn Rune Shards before any runes are unlocked.
• If alternate versions of consumables have been unlocked (for example, Charged Keys or Mega Chests), any cards that can spawn that type of consumables (for example, Ace of Spades or VIII - Justice?) have a chance of being replaced with those rarer consumables.
  • Key Rings are the only exception to this.
• Using XV - The Devil? during the Satan fight in Sheol will instantly kill Isaac, as it invokes the Bible effect.
• If Tarot Cloth is held, and the currently held card has Tarot Cloth effects, the card will flash, indicating that it will be amplified by Tarot Cloth.
• Using any teleport cards while inside of The Beast fight will simply move Isaac instantly to a different spot in the same room. This also includes the Joker card.
• Soul of Cain's effect can open any door that Cracked Orb can, including the Strange Door and door to Mega Satan.
• Using Soul of The Lost and then beating a boss for a completion mark within the same room will not count as a completion mark for The Lost. Instead, the completion mark and achievement will go to the character who used the soul stone.
• For the purposes of tracking Heartbreak's effect on The Lost / Tainted Lost, VI - The Lovers? doesn't add any hidden Broken Hearts to their healthbar, allowing them to use the card without penalty.
• Items granted by Soul of Lilith do not count as collected, and can still spawn in any pool they're in. Familiars obtained this way contribute toward transformations such as Conjoined.
• Soul of Lilith takes its familiars from the Baby Shop item pool; however, when Isaac's stuff is rerolled, those familiars are rerolled in the Treasure Room item pool.
• Items granted by Soul of Lilith can be destroyed by Void / Abyss for their respective bonuses right after using the soul stone while the pedestal pickup animation is playing.
• Characters granted by Souls of the Forgotten / Jacob & Esau can interact with Blood Donation Machines, Devil Beggars, and Hell Games, allowing The Lost and Tainted Lost to safely use them without dying, or a form of invulnerability.
• Characters granted by Souls of the Forgotten / Jacob & Esau can't be used to leave a room, thus they can't be used to negate damage from exiting a Curse Room.
  • They also cannot pick up items, nor can they pick up things such as pills/cards/soul stones. They can pick up hearts, however Soul of the Forgotten can only replenish its bone hearts by collecting a bone heart pickup.
• Items granted to Esau when summoned from the Soul of Jacob and Esau will remove those items from their respective pools as if the player had obtained them. This also prevents future uses of the soul stone from giving that item to Esau.
• When the Soul of Jacob and Esau is used, some items given to Esau will also apply to Isaac for the floor. This happens with Black Candle and mapping items such as The Compass, for example.
  • If Esau is given PHD / False PHD, pills will remain identified for the rest of the run, even if negative pills aren't converted into positive ones.
  • If Esau is given Eden's Blessing, an extra item will be given to Isaac at the start of the next run.

Unlockable Achievements

• 

  The Necronomicon - Use XIII - Death 4 times.

• 

  Blinding Baby - Use Blank Card while holding XIX - The Sun.

• 

  Ancient Recall - Use Cards and Runes 20 times.

• 

  Huge Growth - Increase in size 5 times in a single run via Magic Mushroom, "One makes you larger" pills, XI - Strength, etc..

• 

  Baby-Bender - Use I - The Magician or Telepathy For Dummies while already having homing tears.

In-game footage

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Trivia

• The appearance of the tarot cards seems to be based on the Universal Tarot of Marseille deck produced by Lo Scarabeo, most clearly seen with the card backs as well as the splash image that appears when using The Sun.
• The runes and their names ingame are based on the Elder Futhark alphabet system and its reconstructed Proto-Germanic names. In popular culture, runes often signify that something is in some way magical.
• The Suicide King card is a nickname for the King of Hearts, referred to as such because its artwork depicts a king who seems to be sticking a sword into his own head.
• Ancient Recall, Era Walk, Huge Growth, and Chaos Card are all based on cards from Magic: The Gathering.
• A NULL card with ID 0 exists, revealed by the "giveitem k0" Debug Console command. It can't be acquired or used in any way.
• Many cards were given new unique back sprites in Booster Pack #5, some originating from Antibirth.
• Soul of Cain's ability is likely a reference to Red Key being an unlock for Cain in the original Antibirth mod.
• Soul of Judas' description and ability are a reference to the Spy from Team Fortress 2.
• Soul of Samson's description is a reference to Judges: it is said that Samson killed an army of 1,000 Philistines using a donkey's jawbone.
• Soul of Eve's description is a reference to the original description Birthright had when taken as Eve in the original Antibirth mod.
• The Reverse Tarot Cards refer to tarot card readings, where a reversed card has a contrary meaning to its upright variant.

Bugs

Bug!	Any blue flies, blue spiders, friendly enemies, locusts, orbital bones, and wisps created by cards, runes, and soul stones can be multiplied when Glowing Hourglass teleports Isaac in a way that does not move him to a different room from the one he is currently in (such as by teleporting to the previous room then using it again).

Bug!	As Tainted Lazarus, all effects of XIX - The Sun? except bone heart conversion and sprite change will disappear when flipping.

Bug!	Entering the Knife Piece 2 area while under the effects of XIX - The Sun? will cause a visual bug wherein Isaac will revert to his default appearance but still be capable of flight and spectral tears.

Bug!	If an activated collectible on a pedestal is touched and then rerolled with Soul of Isaac, the alternate item(s) will also count as "already picked up": they will not drop pickups, grant health or transformations they normally would.

Bug!	If multiple Souls of the Forgotten / Jacob & Esau are used in the same room, only 1 Forgotten/Esau will be removed after leaving the room. For every room that is left, one copy of them will disappear.

Bug!	When using Strength?, any segmented bosses are able to be one-shot due to the way segmented bosses are handled.

References

The Binding of Isaac: Rebirth
Achievements Challenges Completion Marks Items Trinkets Characters Chapters Rooms Transformations Attributes Bosses Monsters Pickups Modes Curses Objects Seeds Effects Endings
Collection Item Pools Version History Modding Music