Tears

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This article is about the attribute. For Isaac's primary weapon, see effects.

Tears Stat Icon.png The Tears attribute affects the rate of fire of the character and is represented by 3 arrows. This attribute is related to tear delay (the delay between successive shots, as opposed to the inverse 'tears per second'); a higher tears stat means a shorter delay and a higher fire rate. The tear stat is a measurement of tear frequency, as opposed to Shot Speed, which measures how fast those shots move.

Tear Delay Calculation

The formula for tear delay is:

Tear Delay={166×T×1.3+1T0166×T×1.3+16×TT<0 and T>0.77166×TT0.77

"T" in the above formula is equal to the normal tears stat, with all adjustments added together. (except in Repentance) Tear Delay is always rounded down to next whole number. For example, picking up Collectible The Sad Onion icon.pngThe Sad Onion would grant 0.7 tears, making Isaac's tear delay 7.7, which is rounded down to 7.

The minimum tear delay that can be reached with regular tears up items is 5, giving Isaac a soft cap of 5 tears fired per second. (except in Repentance) With items that directly reduce tear delay, tear delay can be reduced further, down to a hard minimum of 1 tear delay (15 tears fired per second).

The number of tears per second that Isaac fires is found by the formula: 30Tear Delay+1.

Conversely, Tear Delay can be calculated from the fire rate given ingame with the formula 30Fire Rate1. Note that the fire rate given by the ingame HUD is rounded.

(in Repentance) Tear delay as a mechanic is no longer as significant in Repentance, and instead items that used to affect the tear delay now instead affect the fire rate directly. Effectively, this means tear delay can be less than 1.

  • The absolute maximum fire rate achievable is 120, corresponding to -0.75 tear delay.

Characters

Different characters start with different initial tears:

Direct modifiers to Tear Delay/(in Repentance) Tears Fired per Second

Several items directly modify tear delay after the main calculation:

  • (in Repentance) Many items that used to modify tear delay now modify tears fired per second instead. They still allow the soft cap of 5 tears per second to be broken, but now have a greater impact on runs that have a lower fire rate compared to those with a higher one; this is in contrast to Afterbirth+, where the opposite was true. Generally, for these items, each unit of tear delay in Afterbirth+ and before converts to +0.5 tears per second in Repentance.
Item (except in Repentance) Tear delay adjustment (in Repentance) Fire rate adjustment
Collectible Anti-Gravity icon.pngAnti-Gravity -2 +1
Collectible Brimstone icon.pngBrimstone x3 x1/3
CancerCancer -2 +1
Collectible Capricorn icon.pngCapricorn -1 +0.5
Collectible Chocolate Milk icon.pngChocolate Milk x2.5 (for maximum charge) No change, displayed value = maximum charge time
(in Afterbirth † and Repentance)Cracked CrownCracked Crown x0.8 Fire rate over base value x1.2
Collectible Cricket's Body icon.pngCricket's Body -1 +0.5
(in Afterbirth † and Repentance)Collectible Dataminer icon.pngDataminer N/A ±0.5
Collectible Dr. Fetus icon.pngDr. Fetus x2.5 x0.4
(except in Rebirth)Collectible Epiphora icon.pngEpiphora x0.5 (while at maximum "charge") x2 (while at maximum "charge")
Collectible Eve's Mascara icon.pngEve's Mascara x2 x0.66
Collectible Experimental Treatment icon.pngExperimental Treatment N/A ±0.5
Collectible Guillotine icon.pngGuillotine -1 +0.5
(in Afterbirth † and Repentance)Collectible Haemolacria icon.pngHaemolacria x2, then +10 Tear delay adjustment, not fire rate
(in Afterbirth † and Repentance)Collectible Hallowed Ground icon.pngHallowed Ground x0.5 x2.5
Collectible Ipecac icon.pngIpecac x2, then +10 x1/3
(except in Rebirth)Collectible Milk! icon.pngMilk! -2 +1
Collectible Missing No. icon.pngMissing No. N/A ±0.5
Collectible Mom's Perfume icon.pngMom's Perfume -1 +0.5
Collectible Monstro's Lung icon.pngMonstro's Lung x4.3 x1/4.3
Collectible Mutant Spider icon.pngMutant Spider x2.1, then +3 x0.42
Collectible Pisces icon.pngPisces -1 +0.5
Collectible Polyphemus icon.pngPolyphemus x2.1, then +3 x0.42
(except in Rebirth)Collectible Purity icon.pngPurity -4 +2
Collectible Soy Milk icon.pngSoy Milk x0.25, then -2 x5.5
Collectible Technology 2 icon.pngTechnology 2 N/A x0.66
Collectible The Inner Eye icon.pngThe Inner Eye/(in Repentance)XII - The Hanged Man?XII - The Hanged Man? x2.1, then +3 x0.51
(except in Rebirth)Collectible Tractor Beam icon.pngTractor Beam N/A +1
(in Afterbirth † and Repentance)Collectible Brittle Bones icon.pngBrittle Bones N/A +0.4 per bone heart lost
(in Afterbirth † and Repentance)Collectible Dark Prince's Crown icon.pngDark Prince's Crown N/A +2
(in Afterbirth † and Repentance)Collectible Death's List icon.pngDeath's List/(in Afterbirth † and Repentance)Collectible Void icon.pngVoid/(in Afterbirth † and Repentance)Black RuneBlack Rune N/A +0.5
(in Repentance)Collectible Almond Milk icon.pngAlmond Milk N/A x4
(in Repentance)Collectible Berserk! icon.pngBerserk!/(in Repentance)Soul of SamsonSoul of Samson N/A x0.5, then +2
(in Repentance)Collectible Bloody Gust icon.pngBloody Gust N/A Up to +3 after taking damage 6 times
(in Repentance)VII - The Chariot?VII - The Chariot? N/A x4
(in Repentance)Collectible Consolation Prize icon.pngConsolation Prize N/A +0.5
(in Repentance)III - The Empress?III - The Empress? N/A +1.5
(in Repentance)Collectible Eye Drops icon.pngEye Drops N/A x1.2
(in Repentance)Collectible IBS icon.pngIBS/(in Repentance)Soul of ???Soul of ???/(in Repentance) Character Tainted ??? icon.pngTainted ??? N/A +1.5 while on unique creep
Additional x3 if the creep is in contact with white poop
(in Repentance)Collectible It Hurts icon.pngIt Hurts N/A +1.2 on the first hit, then +0.4 on subsequent hits
(in Repentance)Collectible Luna icon.pngLuna N/A +1 for the first beam of light, then +0.5 for subsequent beams
(in Repentance)Collectible Paschal Candle icon.pngPaschal Candle N/A +0.4 for every room cleared without taking non-self damage, up to +2 total
(in Repentance)Collectible Wavy Cap icon.pngWavy Cap N/A +0.75 (halved if Isaac leaves the room, and wears off at the rate of one room clear per use)

Notes

  • Assuming no other modifications to the tears stat, +1.4 tears up is enough to bring you to the normal delay cap. In this case, it would reduce the delay to 5.92, which rounds down to 5.
  • With a tear delay of 1, the maximum achievable rate of fire is 15 tears per second (every 2 frames).
  • Polyphemus, Mutant Spider, and Inner Eye's tear delay formulas do not stack with each other, meaning that there is no downside to taking another after you have already taken one.
  • (except in Repentance) Charge-bar items like Monstro's Lung or Brimstone stop working at 30 tears per second.

Items that affect tears

Activated Items

Name ID Icon Quote Description (in Repentance) Quality
D100 5.100.283
D100
6 rooms
REEROLLLLL! (except in Repentance) Combines the effects of Collectible D4 icon.pngD4, Collectible The D6 icon.pngThe D6, and Collectible D20 icon.pngD20.
(in Repentance) Combines the effects of Collectible D1 icon.pngD1, Collectible D4 icon.pngD4, Collectible The D6 icon.pngThe D6, Collectible D7 icon.pngD7, Collectible D8 icon.pngD8, Collectible D10 icon.pngD10, Collectible D12 icon.pngD12, and Collectible D20 icon.pngD20.
3
(except in Rebirth) D8 5.100.406
D8
4 rooms
Reroll stats Re-rolls Isaac's damage, tears, range, and speed. 2
(in Afterbirth † and Repentance) Dataminer 5.100.481
Dataminer
4 rooms
109 Displaces enemy sprites for the current room, randomly increases one stat and decreases another. 0
(in Afterbirth † and Repentance) Void 5.100.477
Void
6 rooms
Consume Consumes all pedestal items in the room. Active items will have their effects added to Void, and passive items will grant random stat upgrades. 4
(in Repentance) Berserk! 5.100.704
Berserk!
With damage dealt
Rip and tear Isaac goes berserk for 5 seconds, greatly increasing his speed, tears, and damage, but restricting him to using a melee weapon instead of his tears. This item charges by dealing damage to enemies instead of clearing rooms. 2
(in Repentance) Mega Mush 5.100.625
Mega Mush
12 rooms
I'm a big boy now! Gigantifies Isaac for 30 seconds, increasing damage and range while lowering tears, granting invulnerability, and allowing Isaac to crush enemies and obstacles he walks on. The effect persists between rooms. 4
(in Repentance) Sulfur 5.100.556
Sulfur
3 rooms
Temporary demon form Grants Collectible Brimstone icon.pngBrimstone for the current room. 3
(in Repentance) Wavy Cap 5.100.582
Wavy Cap
0.5 seconds
Tears up. A mind changing experience! Increases fire rate, decreases speed, and distorts the screen. All effects become more pronounced with repeated use, and wear off by clearing rooms. 1

Passive Items

Name ID Icon Quote Description (in Repentance) Quality
Anti-Gravity 5.100.222 Anti-Gravity Anti-gravity tears + tears up Tears float in position until firing ceases, after which they will fly off in the direction they were shot in. (except in Repentance) -2 Tear Delay. (in Repentance) +1 Fire Rate. 2
Blue Cap 5.100.342 Blue Cap HP + tears up + shot speed down Gives one full Red Heart container, +0.7 tears, and -0.16 shot speed. (in Repentance) Heals 1 additional Red Heart.pngRed Heart. 3
Brimstone 5.100.118 Brimstone Blood laser barrage Tears are replaced with a blood laser beam that pierces through all enemies and obstacles in its path and deals high damage. Can only be fired after a short charge-up period. 4
Capricorn 5.100.307 Capricorn All stats up (except in Repentance) Adds 1 Red Heart Container, gives +0.5 Damage, +0.1 Speed, +1.5 Range, and -1.0 Tear Delay, and gives 1 Bomb.pngBomb, Penny.pngPenny, and Key.pngKey.
(in Repentance) Adds 1 Red Heart Container, gives +0.5 Damage, +0.1 Speed, +0.75 Range, and +0.5 Fire Rate, and gives 1 Bomb.pngBomb, Penny.pngPenny, and Key.pngKey.
3
Chocolate Milk 5.100.69 Chocolate Milk Charge shots Grants charged tears that deal greater damage when fully charged. 3
Cricket's Body 5.100.224 Cricket's Body Bursting shots + tears up When tears hit an object or deplete their range, they spawn 4 smaller tears, whose range and damage scale with Isaac's. (except in Repentance) Grants -1 tear delay and reduces range. (in Repentance) Grants +0.5 fire rate and reduces range. 3
Death's Touch 5.100.237 Death's Touch Piercing shots + DMG up +1.5 damage, -0.3 tears. Tears are replaced with large piercing scythes. 3
Dr. Fetus 5.100.52 Dr. Fetus ??? Tears are replaced by Bomb.pngBombs that benefit from bomb-enhancing effects and slide for a fixed time after being fired. 4
Eve's Mascara 5.100.310 Eve's Mascara DMG up, tears + shot speed down (except in Repentance) Doubles damage, halves tears stat, and greatly reduces shot speed.
(in Repentance) Doubles damage, 0.66x tears multiplier, and greatly reduces shot speed.
3
Experimental Treatment 5.100.240 Experimental Treatment Some stats up, some stats down (in Rebirth and Afterbirth) Randomly increases and decreases some of Isaac's stats.
(in Afterbirth † and Repentance) Increases four random stats and decreases the other two.
1
Godhead 5.100.331 Godhead God tears (except in Repentance) Grants homing tears with a damaging halo. +0.5 Damage, -0.3 Tears -0.3 Shot Speed, +0.8 Tear Falling Speed, and +1.2 Range.
(in Repentance) Grants homing tears with a damaging halo. +0.5 Damage, -0.3 Tears, and -0.3 Shot Speed.
4
Guillotine 5.100.206 Guillotine DMG + tears up. An out-of-body experience! Isaac's head is removed from his body and floats around him as an orbital. (except in Repentance) Gives +1 damage and grants -1 tear delay. (in Repentance) Gives +1 damage and grants +0.5 fire rate. 2
Ipecac 5.100.149 Ipecac Explosive shots Replaces tears with explosive and poisoning projectiles fired in an arc from the mouth. 4
Libra 5.100.304 Libra You feel balanced Gives 6 Penny.pngCoins, 6 Bomb.pngBombs, and 6 Key.pngKeys and balances out all attributes. 1
Missing No. 5.100.258 Missing No. Syntax error Randomizes all passive items and stats upon pickup and at the start of each succeeding floor. 0
Mom's Perfume 5.100.228 Mom's Perfume Fear shot + tears up Adds a chance to shoot fear tears. (except in Repentance) Decreases tear delay by 1. (in Repentance) +0.5 fire rate. 2
Monstro's Lung 5.100.229 Monstro's Lung Charged burst attack Replaces normal tears with a charged shot that fires 14 tears in the same fashion as Boss Monstro ingame.pngMonstro. 2
Mutant Spider 5.100.153 Mutant Spider Quad shot Isaac shoots four tears at once with lower fire rate. 3
Number One 5.100.6 Number One Tears up + range down Grants +1.5 tears, but severely reduces range. 2
Odd Mushroom 5.100.120 Odd Mushroom Tears + speed up, DMG down +1.7 tears, +0.3 speed, slightly reduces damage. 2
Ouija Board 5.100.115 Ouija Board Spectral tears + tears up Grants spectral tears that travel through obstacles (but not enemies). (in Repentance) +0.5 tears. 2
Pisces 5.100.309 Pisces Tears up + knock-back shots (except in Repentance) -1 Tear Delay, adds knock-back shots and increases tear size.
(in Repentance) +0.5 Fire Rate, adds knock-back shots and increases tear size.
2
Polyphemus 5.100.169 Polyphemus Mega tears Isaac fires huge tears that deal massive damage, but fire rate is greatly decreased. If a tear kills an enemy, it travels on with any leftover damage. 4
Rosary 5.100.72 Rosary Tears + faith up Grants 3 Soul Heart.pngSoul Hearts. Causes Collectible The Bible icon.pngThe Bible to appear in any item pool. (in Repentance) +0.5 tears. 2
Sacred Heart 5.100.182 Sacred Heart Homing shots + DMG up (except in Repentance) Adds a Red Heart Container. Grants homing tears, a x2.3 Damage multiplier, +1 flat Damage, -0.4 Tears, -0.25 Shot Speed, and +4.125 Range.
(in Repentance) Adds a Red Heart Container. Grants homing tears, a x2.3 Damage multiplier, +1 flat Damage, -0.4 Tears, and -0.25 Shot Speed.
4
Screw 5.100.255 Screw Tears + shot speed up +0.5 tears, +0.2 shot speed. 3
SMB Super Fan 5.100.189 SMB Super Fan All stats up (except in Repentance) +1 Red Heart container, +0.3 damage, +0.2 tears, +0.2 speed, +0.5 range, +1 tear falling speed. Fully restores all red hearts.
(in Repentance) +1 Red Heart container, +0.3 damage, +0.2 tears, +0.2 speed, +2.5 range. Fully restores all red hearts.
3
Soy Milk 5.100.330 Soy Milk DMG down + tears way up Tears are smaller and do much less damage, but fire in very rapid succession. 2
Squeezy 5.100.196 Squeezy Tears up +0.4 tears, spawns 2 Soul Heart.pngSoul Hearts. 3
Technology 2 5.100.152 Technology 2 Extra laser Replaces the tears fired from Isaac's right eye with a rapid-firing low damage piercing laser. (except in Repentance) Damage down. 2
The Halo 5.100.101 The Halo All stats up (except in Repentance) Grants one full Red Heart container, +0.3 damage, +0.2 tears, +0.25 range, +0.3 speed, and +0.5 tear falling speed.
(in Repentance) Grants one full Red Heart container, +0.3 damage, +0.2 tears, +1.5 range, and +0.3 speed. Heals 1 additional Red Heart.pngRed Heart.
2
The Inner Eye 5.100.2 The Inner Eye Triple shot Isaac shoots three tears at once with lower fire rate. 2
The Pact 5.100.80 The Pact DMG + tears up (except in Repentance) Grants two Soul Heart.pngSoul Hearts, +0.5 damage, and +0.7 tears.
(in Repentance) Grants two Black Heart.pngBlack Hearts, +0.5 damage, and +0.7 tears.
3
The Sad Onion 5.100.1 The Sad Onion Tears up +0.7 tears. 3
The Small Rock 5.100.90 The Small Rock DMG up + speed down +1 damage, +0.2 tears, -0.2 speed. 3
Tooth Picks 5.100.183 Tooth Picks Tears + shot speed up +0.7 tears, +0.16 shot speed. 3
Torn Photo 5.100.341 Torn Photo Tears + shot speed up +0.7 tears, +0.16 shot speed. 3
Wire Coat Hanger 5.100.32 Wire Coat Hanger Tears up +0.7 tears. 3
(except in Rebirth) Binky 5.100.438 Binky Tears up Grants one Soul Heart.pngSoul Heart, +0.75 tears and decreases Isaac's size. 3
(except in Rebirth) Eden's Blessing 5.100.381 Eden's Blessing Tears up + your future shines brighter +0.7 tears up. Grants a random item at the start of the next run. 3
(except in Rebirth) Epiphora 5.100.368 Epiphora Intensifying tears Shooting in one direction increases Isaac's rate of fire until the cap is reached. As soon as Isaac changes direction or stops shooting, rate of fire is reset to its normal amount. 2
(except in Rebirth) Kidney Stone 5.100.440 Kidney Stone Matt's kidney stone Isaac is occasionally forced to stop firing and charge an attack that launches a massive piercing, spectral kidney stone and a barrage of tears. (except in Repentance) -0.2 speed, decreases range. 2
(except in Rebirth) Marked 5.100.394 Marked Directed tears Isaac will automatically fire tears directed at a red target on the ground. The target can be moved with tear controls. +0.7 tears, increases range. 1
(except in Rebirth) Milk! 5.100.436 Milk! Don't cry over it... Spawns a glass familiar that spills on the floor upon taking damage. (except in Repentance) After the milk spills, Isaac's tear delay is decreased by 2 for the current room. (in Repentance) After the milk spills, Isaac's fire rate is increased by 1 for the current room. 1
(except in Rebirth) Mr. Dolly 5.100.370 Mr. Dolly Range + tears up (except in Repentance) +0.7 tears, +5.25 range, +0.5 tear falling speed, Spawns a combination of 3 Red Heart.pngRed Hearts, Soul Heart.pngSoul Hearts or Black Heart.pngBlack Hearts on the floor when picked up.
(in Repentance) +0.7 tears, +2.5 range, spawns 3 random types of Red Heart.pngHearts on the floor when picked up.
3
(except in Rebirth) Purity 5.100.407 Purity Aura stat boost Boosts one of Isaac's stats depending on the color of the aura around him. The aura disappears upon taking damage and reappears with a random color upon entering a new room. Red boosts damage, blue boosts tears, yellow boosts speed, and orange boosts range. 3
(except in Rebirth) Tractor Beam 5.100.397 Tractor Beam Controlled tears Isaac's tears are bound to a beam emitting in the direction he's firing. (except in Repentance) +0.5 Tears, +5.25 Range, +0.16 Shot Speed. (in Repentance) +1 Fire Rate, +2.5 Range, +0.16 Shot Speed. 3
(except in Rebirth) Zodiac 5.100.392 Zodiac The heavens will change you Gives Isaac a random zodiac item effect that changes every floor. 1
(in Afterbirth † and Repentance) Analog Stick 5.100.465 Analog Stick 360 tears! +0.35 tears up. Allows Isaac to fire tears diagonally. 2
(in Afterbirth † and Repentance) Apple! 5.100.443 Apple! Trick or treat? +0.3 tears. Adds a chance to fire a razor blade that deals 4× Isaac's damage. 3
(in Afterbirth † and Repentance) Brittle Bones 5.100.549 Brittle Bones Everything hurts Replaces all Red Heart.pngRed Heart Containers with 6 empty Bone Heart.pngBone Hearts. (except in Repentance) Upon losing a Bone Heart, Isaac fires bones in 8 directions and permanently gains a tears up. (in Repentance) Upon losing a Bone Heart, Isaac fires bones in 8 directions and permanently gains a fire rate up. 3
(in Afterbirth † and Repentance) Camo Undies 5.100.497 Camo Undies Camo kid Isaac becomes camouflaged at the beginning of each room. Until he shoots, all non-boss enemies will be confused. (in Repentance) Isaac gains +0.5 Speed while camouflaged, and gains Tears and Damage upon breaking it. 3
(in Afterbirth † and Repentance) Dark Prince's Crown 5.100.442 Dark Prince's Crown Loss is power (except in Repentance) When at exactly one Red Heart.pngRed Heart, +0.75 tears, +1.5 range, and +0.2 shot speed.
(in Repentance) When at exactly one Red Heart.pngRed Heart, +2 fire rate, +1.5 range, and +0.2 shot speed.
1
(in Afterbirth † and Repentance) Death's List 5.100.530 Death's List Just hope you're not next... Grants a pickup or stat upgrade if all enemies in a room are killed in the order they are marked. 2
(in Afterbirth † and Repentance) Divorce Papers 5.100.547 Divorce Papers Tears up + you feel empty Grants one Bone Heart.pngBone Heart, +0.7 tears, spawns a Mysterious PaperMysterious Paper. 3
(in Afterbirth † and Repentance) Haemolacria 5.100.531 Haemolacria I'm seeing red... Tears are now fired in an arc. Upon hitting the floor, an obstacle, or an enemy, they burst into many smaller tears in all directions. Increases tear delay. 4
(in Repentance) A Bar of Soap 5.100.564 A Bar of Soap Tears + shot speed up +0.5 Tears, +0.2 Shot Speed. 3
(in Repentance) Act of Contrition 5.100.601 Act of Contrition Tears up, you feel forgiven +0.7 tears, grants an Eternal Heart.pngEternal Heart. Allows Angel RoomAngel Rooms to appear even if a Devil Deal has been taken before. Reduces the Devil/Angel room chance penalty for taking Red heart damage. 3
(in Repentance) Almond Milk 5.100.561 Almond Milk DMG down + tears up + you feel nutty Quadruples fire rate, with ×0.3 damage multiplier. Each tear is a given random effect that alters its movement. 1
(in Repentance) Binge Eater 5.100.664 Binge Eater All you can eat +1 Red Heart Container and fully heals Isaac. Item pedestals also offer a random food item. Picking up a food item temporarily grants +3.6 damage and permanently boosts 2 stats. 4
(in Repentance) Bloody Gust 5.100.695 Bloody Gust May your rage bring haste The first 6 times Isaac takes damage on a given floor, he gains Speed and Fire Rate for the rest of the floor, up to a maximum of +1.02 and +3.00, respectively. 2
(in Repentance) Candy Heart 5.100.671 Candy Heart Power of love Gives Isaac a permanent stat boost whenever he heals with Red Heart.pngRed Heart pickups. 1
(in Repentance) Consolation Prize 5.100.644 Consolation Prize +1 to lowest stat Increases Isaac's lowest stat and drops either 3 Penny.pngCoins, 1 Bomb.pngBomb, or 1 Key.pngKey depending on what Isaac has the least of. 1
(in Repentance) Eye Drops 5.100.600 Eye Drops Tears up Increases the fire rate in Isaac's left eye, causing his eyes to fire at different rates. 3
(in Repentance) It Hurts 5.100.560 It Hurts No it doesn't... Releases a ring of tears and increases fire rate for the current room when Isaac takes damage. 1
(in Repentance) Luna 5.100.589 Luna The moon's blessing shines upon you Adds an extra Secret RoomSecret Room and Super Secret RoomSuper Secret Room to each floor. Secret Rooms contain a beam of light that increases Fire Rate for the current floor and gives a Half Soul Heart.pngHalf Soul Heart. 2
(in Repentance) Paschal Candle 5.100.567 Paschal Candle Keep the flame burning Gives Isaac a familiar that grants +0.4 Fire Rate for each consecutive room he's cleared without taking damage. The bonus stacks up to five times. 3
(in Repentance) Pluto 5.100.598 Pluto Size down +0.7 tears. Significantly shrinks Isaac, allowing him to squeeze between objects and makes some enemy shots pass over him. 3
(in Repentance) Sausage 5.100.669 Sausage All stats up Adds a Red Heart Container, fully heals Isaac, and gives +0.2 Speed, +0.5 Damage, +0.5 Tears, +2.5 Range, +0.2 Shot Speed, and +1.0 Luck. Increases the chance of encountering a Devil RoomDevil Room, Angel RoomAngel Room, and/or PlanetariumPlanetarium each by 6.9%. 3
(in Repentance) Soul Locket 5.100.686 Soul Locket Power of faith Gives Isaac a permanent stat boost whenever he picks up a Soul Heart.pngSoul Heart. 1
(in Repentance) Star of Bethlehem 5.100.651 Star of Bethlehem Follow the light Spawns a star familiar that slowly travels towards the Boss RoomBoss Room, giving an aura that increases damage and tears and grants homing tears. 3

Trinkets

Name ID Icon Quote Description
Cancer 5.350.39 Cancer Yay, cancer! (except in Repentance) -2 tear delay (effectively increases fire rate of tears).
(in Repentance) +1.0 fire rate.
Hook Worm 5.350.26 Hook Worm Zip zoop! (except in Repentance) Tears move shifting left to right on a square-wave-like path. +10 Range (effective Range remains about the same).
(in Repentance) Tears move shifting left to right on a square-wave-like path. +0.4 Tears, +1.5 Range (effective Range is slightly lower).
Liberty Cap 5.350.32 Liberty Cap Touch Fuzzy, Get Dizzy (except in Repentance) Adds a chance when entering a room to gain Collectible Mini Mush icon.pngMini Mush, Collectible Odd Mushroom (Large) icon.pngOdd Mushroom, Collectible Odd Mushroom (Thin) icon.pngOdd Mushroom, or Collectible The Compass icon.pngThe Compass for one room.
(in Repentance) Adds a chance when entering a room to gain a random passive mushroom item for one room.
Ring Worm 5.350.11 Ring Worm Woop woop! Isaac fires in a fast spiraling pattern. (in Repentance) Also grants +0.4 Tears and spectral tears.
Wiggle Worm 5.350.10 Wiggle Worm Wiggle waggle! Isaac's tears travel in a wave-like pattern. +0.4 Tears up. (in Repentance) Also grants spectral tears.
(except in Rebirth) Cracked Dice 5.350.67 Cracked Dice You feel cursed... kinda. (except in Repentance) Activates (in Repentance) Has a chance to activate the effect of Collectible The D6 icon.pngThe D6, Collectible D8 icon.pngD8, (in Repentance)Collectible D10 icon.pngD10, Collectible D12 icon.pngD12, or Collectible D20 icon.pngD20 (chosen randomly) whenever Isaac takes damage.
(except in Rebirth) Rainbow Worm 5.350.64 Rainbow Worm Bleep Bloop Blop Isaac's tears gain a worm effect that changes every 3 seconds.
(in Afterbirth † and Repentance) Cracked Crown 5.350.92 Cracked Crown Stat booster (except in Repentance) Decreases Isaac's tear delay by 20%, and improves the effectiveness of his other stat upgrades by 33%.
(in Repentance) Improves the effectiveness of stat upgrades by 20%.
(in Afterbirth † and Repentance) Dim Bulb 5.350.101 Dim Bulb I think it's broken Provides a boost to all stats when Isaac's active item is completely uncharged.
(in Afterbirth † and Repentance) Ouroboros Worm 5.350.96 Ouroboros Worm Foop foop! Tears travel in a large spiral pattern and gain spectral, with a small chance to gain homing. (in Repentance) Also adds +0.4 Tears.
(in Afterbirth † and Repentance) Vibrant Bulb 5.350.100 Vibrant Bulb It needs power Provides a boost to all stats when Isaac's active item is fully charged.
(in Repentance) Azazel's Stump 5.350.162 Azazel's Stump Unleash your inner demon When clearing a room, adds a chance to turn into Character Azazel icon.pngAzazel until clearing another.
(in Repentance) Broken Syringe 5.350.132 Broken Syringe Mystery medicine Grants a chance to gain a random syringe effect for the current room.

Other