Top 20 Best and Worst Binding of Isaac Items

The Binding of Isaac is a good game. Let’s rank the items.

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10 BEST. Magic Mushroom

“All stats up”

Magic Mushroom is an amazing item that grants an all stats upgrade. The damage increase is very large and there’s good upgrades to all other stats, excluding tears. The only downside is the size up, and I also feel like there’s also just better items.

10 WORST. Dead Cat

“Nine lives”

I see the benefits of this item, but I really don’t understand how this is a guaranteed take for most people. It gives you 9 lives but lowers your health to one. This can be raised using HP up items or pills, but only for your current life. Chances are, if you die in one room, you will the next time. I just hate it, but it’s fantastic for The Lost and Judas, considering it removes the negative side effects for them.

9 BEST. Cricket’s Head

“Damage up”

This item is quite good. It gives a small damage upgrade, but a huge damage modifier. This means it gets better the later you pick it up. Not much else to say, it’s just good.

9 WORST. Soy Milk

“Damage down + tears way up”

This item has amazing synergies, like Libra, Death’s Touch, and Godhead. But on it’s own, this item is pure crap. It doesn’t actually affect your DPS, or damage per second, but the knockback is miserable. It makes it so hitting enemies is a Herculean feat. Only pick this up is you have piercing and or Libra. Oh yeah, and it’s garbage with Brimstone too. Huh.

8 BEST. Abaddon

“Evil + damage up + fear shot”

UNLOCKED BY: Kill ??? as Azazel

This item does it all. It takes away your red hearts, replaces them with six black hearts, gives you a damage upgrade, and adds a chance to fire fear tears. What else is there to say, it’s just good. Just a word of caution, though: it instantly kills Keeper. Also, maybe don’t take it if you have like 12 red hearts.

8 WORST. The Halo

“All stats up”

UNLOCKED BY: Kill Mom or Mom’s Heart using The Bible

Realistically, this is not the eighth worst Isaac item. But in terms of overrated items, this absolutely makes the list. This barely does anything. It gives a minute damage and tears up, a size up, and an HP up. It does not deserve to be compared with Magic Mushroom.

7 BEST. Godhead

“God tears”

UNLOCKED BY: Fill out The Lost’s sticky note on hard mode

I’m gonna say something here: I haven’t unlocked Godhead. But I’ve given myself it using the console to test it out, and it’s great. It gives a small damage up, as well as a large damaging halo around your tears. It’s pretty freaking fantastic, but probably not worth the suffering necessary to unlock it.

7 WORST. The Inner Eye

“Triple shot”

I know I’m doing a lot of very controversial picks, but The Inner Eye is almost always a negative. It vastly decreases your tear rate for a crappy triple shot. Garbage, especially compared to 20/20 or Mutant Spider. Speaking of...

6 BEST. Mutant Spider

“Quadruple shot”

Not a run-winner, but definitely a run-carrier. It grants a quadruple shot with closer spread, along with a less bad tears down than The Inner Eye. It’s just great, and it synergizes with most items.

6 WORST. Holy Water

“Splash”

This item barely does anything. If you get hit, it spills and creates a small pool of creep. That’s it. You could get Sacred Heart, but nope, this garbage. Great.

5 BEST. Tech X

“Laser ring tears”

Now we’re getting into the good stuff. Tech X changes your tears into large laser rings, which can also be focused into smaller laser rings. This is a run-carrier item. Always pick it up.

5 WORST. Abel

“Mirrored buddy”

UNLOCKED BY: Kill the Lamb as Cain

I don’t think this has any effect on your run. Abel is just kinda there. Not doing anything. Why does he even exist? No one knows. And no one cares. Oh yeah, I forgot to say what he does. He mirrors your movements and fires crappy tears. Yay.

4 BEST. Polyphemus

“Mega tears”

This item makes your tears giant while giving you a tears down. This item is amazing. Not much else to say. It also makes your tears carry on with the leftover damage after killing an enemy, so that’s cool, I guess.

4 WORST. Kamikaze

“Become the bomb”

Oof. Deal yourself one heart of damage to explode once. Literally only good if you have Pyromaniac. Otherwise, don’t pick this up.

3 BEST. Ipecac

“Explosive shots”

UNLOCKED BY: Kill Mom’s Heart 6 times

This item makes your tears become arcing explosions that deal 40 DAMAGE. For reference, your base damage is about 3.5. This item’s one downside is that you can hurt yourself with it, but if you’re careful, that won’t happen.

3 WORST. The Bean

“Toot on command”

Just no. It makes you do a small fart that poisons nearby enemies and that’s it. Why.

2 BEST. Brimstone

“Blood laser barrage”

This is probably the most iconic item in Isaac, and there’s a good reason why. It turns your tears into giant piercing and spectral laser beams that deal copious amounts of damage and extend through the whole room. It’s just good.

2 WORST. Butter Bean

“Reusable knockback”

UNLOCKED BY: Destroy 100 poops

It makes you do a small knockback fart. That’s it.

1 BEST. Sacred Heart

“Homing shots + damage up”

This item gives you a massive damage up plus homing shots plus a health up plus homing bombs. This item has no downsides. It’s just amazing.

1 WORST. Plan C

“Use with caution”

UNLOCKED BY: Kill Ultra Greedier as Lazarus

It kills every enemy in the room and, three seconds later, kills you. Amazing.