At the start of every floor, generates a ladder which leads to a special Angel Room Shop, regardless of whether a devil deal has been taken. These angel shops always contain the following:
Three items/pickups for sale. These items/pickups can be on sale, just like with normal Shops.
Weight decrementation in the generated shops is the same as in regular Angel Rooms, so if an item is seen in the special shop, it won't be encountered regularly again for the rest of the run.
During the Ascent, ladders will generate in the "starting rooms" (where light beams are located) on every floor.
The same does not apply during Backasswards (challenge #31), in which the item simply has no effect.
The ladder will appear in the Mirrored World in the starting room, and will lead to the same shop.
Rerolled items in the room will be taken from the Angel Room pool.
Since a beggar always spawns immediately to the right of the entrance way, caution should be taken to avoid accidental donation.
If a run is started with The Stairway, i.e. playing as Eden or having collected Eden's Blessing, the ladder will not appear on the first floor.
In Greed mode, the ladder does not go away when pressing the button to start the waves. This means money can be gathered from the waves before entering the Stairway shop.
Death Certificate: An additional ladder will spawn in one room of the Death Certificate area. This ladder leads to the same Angel Shop as the one in the starting room of the floor. Purchasing an item will remove Isaac from the Death Certificate area as though he had collected an item normally. Sometimes, the ladder will spawn directly on top of an item pedestal, making the Angel Shop impossible to enter without collecting that item and subsequently being removed from the area.
Keeper's Sack: Buying items grants stats, same as with other shops.
This item was originally called Jacob's Ladder in the Antibirth mod but was changed to avoid confusion between this item and the existing Jacob's Ladder. In Antibirth, the ladder would take Isaac to a regular Angel Room instead of a unique Angel Shop, however using the ladder prevented an Angel or Devil Room from appearing after fighting the boss. The ladder would also not disappear when Isaac left the starting room.
The name is a reference to The Book of Genesis from the Old Testament. In Genesis 28:10-19 Jacob rested on his journey and had a dream; in the dream, he saw a ladder that served as the connection between Heaven and Earth.
This item's name and its flavor text are a reference to the Led Zeppelin song "Stairway to Heaven."
Angel Room Shop, regardless of whether a devil deal has been taken. These angel shops always contain the following:
Shops.
Eternal Heart for 5 pennies.
Soul Heart for 5 pennies.
Key for 5 pennies.
Holy Card for 5 pennies.
Beggar or 
Rotten Beggar next to the entrance.
Confessional, if it has been unlocked.
Eden or having collected 
Eden's Blessing, the ladder will not appear on the first floor.
Adoption Papers: Does not affect the Angel shop.
Coupon / 
Credit Card / 
Mr. ME!: Can be used to obtain items for free.
Death Certificate: An additional ladder will spawn in one room of the Death Certificate area. This ladder leads to the same Angel Shop as the one in the starting room of the floor. Purchasing an item will remove Isaac from the Death Certificate area as though he had collected an item normally. Sometimes, the ladder will spawn directly on top of an item pedestal, making the Angel Shop impossible to enter without collecting that item and subsequently being removed from the area.
Keeper's Sack: Buying items grants stats, same as with other shops.
A Pound of Flesh: Makes Angel Shops cost health just like regular 
Restock / 
Store Credit: No effect in the Angel shop.
Steam Sale: Reduces the prices of the items on offer.
Jacob's Ladder. In Antibirth, the ladder would take Isaac to a regular Angel Room instead of a unique Angel Shop, however using the ladder prevented an Angel or Devil Room from appearing after fighting the boss. The ladder would also not disappear when Isaac left the starting room.
Jacob and Esau Unlocks 
Isaac (Boss) Unlocks 
The Binding of Isaac: Rebirth
