Dezmiatu

Taking the level and item layout of the original Zelda, they're used in this story where isaac must escape his mothe's desire to sacrifice him to God. Our protagonist is naked and starts with only his tears to fight off the maggots, fetuses, abandoned children, flies, and other hazards as he travels deep into the bowels of the world. He depends on finding items angelic, animal parts, and deals with Satan himself in order to survive and ultimately defeat his mother. High replay value thanks to randomizing and a large selection of items. Personally find the nuttier, underpowered combinations the most fun.