Rebirth Unlock Guide

A complete guide to unlocking every item in The Binding of Isaac: Rebirth. Heavy spoilers ahead!

Introduction

Hello and welcome to The Binding of Isaac: Rebirth unlock guide. This guide will show you how to obtain all of the locked items in this game, as well as achievements that go with it.

Please note that there will be major spoilers ahead. This is your first and only warning. If you do not want the game spoiled for you, please do not read past this section. Also assume that all links in this guide will also lead to spoilers.

I will attempt to make this guide as complete as possible, but mistakes can happen. If you find a mistake, please report it in the comments, either here or on my profile, so that I can fix it. All data has been pulled from The Binding of Isaac: Rebirth Cheat Sheet from the fine folks over at Platinum God[platinumgod.co.uk]. Unless otherwise stated all images have been pulled from the game's files.

As of yet, this guide does not feature unlocks for trinkets, cards and runes. That's for the future - though I'm sure there are other guides dealing with that already.

The guide is organized in sections based on how the order in which the items are most likely to be unlocked. If you want to quickly find how to unlock a particular item, you can hit CTRL+F (or the equivalent for your browser's search function) to find that item.

Thank you for reading!

-- [SgC]Ruby

Updates

2014-11-27 - This got big quickly! Thank you everyone for suggesting fixes, and a big thank you to /r/BindingOfIsaac mods for putting a link to this guide in the sidebar of the subreddit. I'll work on adding unlocks for trinkets and cards today!

Your First Runs

Items in this section will be unlocked as you go through your first few runs.

Monstro's Tooth

How to get: Beat Basement II (second level of the game)
What it does: Active item. Once used, summons Monstro to fall from the sky, stomping enemies for some damage. Usable every three rooms.

Little Chubby

How to get: Beat Caves II (fourth level of the game)
What it does: Passive item. Gives you a small familiar that follows you around and charges in your attack direction, dealing high damage.

Cube of Meat

How to get: Beat Mom for the first time.
What it does: Passive item. Gives you an orbital which deals contact damage to enemies and blocks enemy tears. Can be collected up to four times, in which case it grows and starts shooting tears and eventually transforms into a meat boy which detaches from you and deals damage to enemies.

Book of Revelations

How to get: Defeat one of the Horsemen of the Apocalypse. Most likely it will be Famine, as it's a fairly common boss on the Basement.
What it does: Active item. Once used, gives you a soul heart (blue heart) and gives you a higher chance to fight a horseman at the end of the floor. Usable every six rooms.

Mom's Heart Items

After you have defeated Mom once, you will unlock an additional set of floors - The Womb. The final boss of Womb II will be Mom's Heart - you need to defeat it 11 times in order to unlock one final set of floors. Every time you defeat Mom's Heart, one secret will get unlocked - however, it will not always be an item.

Rubber Cement

How to get: Defeat Mom's Heart 2 times.
What it does: Passive item. Makes your tears bounce off from walls and enemies.

Transcendence

How to get: Defeat Mom's Heart 3 times.
What it does: Passive item. Grants you the ability to fly over rocks and other obstacles.

Wire Coat Hanger

How to get: Defeat Mom's Heart 4 times.
What it does: Passive item. Increases your tears (the rate at which you fire your tears).

IPECAC

(I.P.E.C.A.C.)
How to get: Defeat Mom's Heart 6 times.
What it does: Passive item. You shoot poison bombs instead of tears (similar to Sloth and those green exploding enemies in the Caves).

Experimental Treatment

How to get: Defeat Mom's Heart 7 times.
What it does: Passive item. Increases all of your stats, then shuffles them.

A Quarter

How to get: Defeat Mom's Heart 8 times.
What it does: Passive item. Gives you 25 cents.

Dr. Fetus

How to get: Defeat Mom's Heart 9 times.
What it does: Passive items. You shoot regular bombs instead of tears (similar to Wrath).

Upon defeating Mom's Heart for the 11th time, that boss will be replaced with a somewhat harder version (It Lives!), and you will be granted access to the final set of floors.

Intermediate Unlocks

While you're doing your 11 Mom's Heart kills, you might want to pay attention to these achievements. Most of these will unlock naturally as you play the game, but you might find it to your advantage to unlock them sooner.

The Necronomicon

How to unlock: Use Death tarot card four times. Not necessarily during one run.
What it does: Active item. Deals moderate damage to every enemy in the room. Best used in big rooms. Usable every six rooms.

Loki's Horns

How to unlock: Defeat Lokii. Lokii is the double (split) Lokii found in the Womb, and not the regular Loki found in the Depths.
What it does: Passive item. Your character now has a chance to shoot in all four cardinal directions.

Mr. Mega

How to unlock: Blow up 10 tinted rocks. Tinted rocks are rocks which appear randomly on the floor and have a small "X" engraved on them. On the Basement, those rocks are also of a different shade. You can use bombs or a "stompy" item such as Leo to destroy them.
What it does: Passive item. Grants you 5 bombs and gives all of your bombs stronger explosions and bigger blast radius.

The Small Rock

How to unlock: Destroy 100 tinted rocks.
What it does: Passive item. Increases your damage. You can get this item randomly after blowing up a tinted rock.

The Book of Sin

How to unlock: Beat each of the seven sins (Greed, Wrath, Sloth, Lust, Pride, Gluttony, Envy) at least once. As you can't influence when these will appear, it might take a while until you unlock this item, however it will usually happen fairly quickly.
What it does: Active item. Spawns a random pickup item (bombs, hearts, keys, coins...) on use. Usable every four rooms.

Butter Bean

How to unlock: Destroy 100 poops. (Shoot tears in their general direction). Very easy to acquire if you complete challenge #12 ("When Life Gives You Lemons") and get A Card Against Humanity card which fills up the room with poop. Use it on a large room, preferably as Azazel or with a stompy item, and knock yourself off.
What it does: Active item. Knocks enemies away (similar to the farting enemies in Basement). Usable every four seconds.

Head of Krampus

How to unlock: First, make 20 deals with the devil. To maximize your devil deal chances, don't take red heart damage on the floor prior to fighting the boss (taking soul heart and black heart damage is okay). Krampus will appear randomly in one of your next Devil Rooms. He has a 50% chance to drop this item.
What it does: Active item. Fires a powerful Brimstone laser in all four cardinal directions. Usable every third room.

Little Steven

How to unlock: Beat Basement 40 times. After that, Steven will randomly appear as a boss on one of the Basement floors. Killing him will yield you either this item or the Steven item.
What it does: Passive item. A familiar which shoots homing tears.

Steven

How to unlock: Beat Basement 40 times. After that, Steven will randomly appear as a boss on one of the Basement floors. Killing him will yield you either this item or the Little Steven item.
What it does: Passive item. Damage up.

Little C.H.A.D.

(Little CHAD)
How to unlock: Beat Caves 30 times. After that, C.H.A.D. will randomly appear as a boss on one of the Caves floors. Defeating him will yield you this item. It can also be found in item rooms after that.
What it does: Passive item. Drops half-red-hearts every few rooms.

Little Gish

How to unlock: Beat the Depths 20 times. After that, Gish will randomly appear as a bos on Depths I. Defeating him will yield you this item. It can also be found in item rooms after that.
What it does: Passive item. A familiar which shoots slowing tears.

Scissors

How to unlock: Die 100 times.
What it does: Active item. Separates your character's head and body. You control the body and fire tears from both your body and your head. Usable every 6 rooms.

The Halo

How to unlock: Use The Bible (active item) during the Mom fight.
What it does: Passive item. Increases all of your stats.

Super Bandage

How to unlock: Build a Bandage Girl by collecting four Balls of Bandages. As Ball of Bandages has a 50% chance to drop from any horseman, you need to be somewhat lucky to complete this. Having Book of Revelations from the start is strongly recommended to ensure that you fight a horseman every set of floors.
What it does: Passive item. Grants you a health up and two soul hearts.

Guppy's Hair Ball

(Guppy's Hairball)
How to unlock: Become Guppy. Pick up any three of the following items: Dead Cat, Guppy's Collar, Guppy's Head, Guppy's Paw, Guppy's Tail (you just need to touch the active items, no need to keep them with you). This will grant you flight and you will spawn kamikaze flies that do twice your damage every time you or your familiar hit with a tear, essentially tripling your damage.
What it does: Passive item. It's a flail that you can swing around yourself to damage enemies. It also blocks tears and grows in size as you kill stuff with it, and its size is reset at the beginning of each floor.

The Parasite

How to unlock: In one run, have two of these items at once: Bob's Rotten Head, Tammy's Head, Dead Cat, Cricket's Head. Bob's Rotten Head and Dead Cat are fairly common items, so unlocking this should not be hard. Dead Cat is commonly found in red chests and devil rooms and Bob's Rotten Head can be found in item rooms and secret rooms.
What it does: Passive item. It makes your tears split after they hit a target.

Mom's Contacts

How to unlock: In one run, hold any three "Mom" items at once (items starting with "Mom's...")
What it does Passive item. Your character has a chance to shoot a tear which freezes enemies on contact for a brief period of time.

Little Baggy

How to unlock: In one run, have two of these items at once: Roid Rage, The Virus, Growth Hormones, Experimental Treatment, Speed Ball (the syringes, minus Synthoil). The Virus can drop from Lust, and the rest can be found in Boss Trap Rooms, as drops from bosses or in the item room.
What it does: Passive item. Enables you to hold two pills and disables card drops.

Arcade Unlocks

These items need to be unlocked by playing machines in the Arcade. Arcades have a chance to spawn on second of every set of floors (i.e. Basement II, Caves II, Depths II, Womb II) if you have at least 5 cents. It costs one cent to enter an arcade.

The Gamekid

(Game Kid; Game Boy; Gameboy)
How to unlock: Enter 10 arcades.
What it does: Active item. You gain short invincibility and can damage enemies on touch. You also restore one half-heart for every two enemies killed. Usable every six rooms.

Blood Bag

How to unlock: Play a blood donation machine (blood bank) 30 times over any amount of runs. After that, it has a chance to appear after using the blood donation machine.
What it does: Restores four red hearts, grants you a health up and a speed up.

The D4

How to unlock: Destroy 30 slot machines over any amount of runs. Simply place a bomb near them to blow them up.
What it does: Rerolls your entire character build and changes all of your items except your active item and your current trinket. You may also gain items you have not unlocked yet in this manner (though they will not be permanently unlocked). You can't use it in the Sheol or the Dark Room.

Shop Unlocks

These items will become available as you donate money to the donation machine located in the shop and, sometimes, in the arcade.

Blue Map

How to get: Give 10 pennies to the donation machine in the shop.
What it does: Passive item. Once bought, displays both secret rooms on the map.

There's Options

How to unlock: Donate 50 pennies.
What it does: Passive item. Lets you choose between two items after defeating any boss - a "reroll" of sorts.

Black Candle

How to unlock: Donate 150 pennies.
What it does: Passive item. Grants you immunity to floor curses and a single black heart.

Red Candle

How to unlock: Donate 400 pennies.
What it does: Active item. Throws a flame that deals damage. The flame will remain active until it is depleted by dealing damage or until you change rooms. Can be used every several seconds.

The Candle

(Blue Candle)
How to unlock: Donate 900 pennies.
What it does: Active item. Throws a flame that deals high damage and destroys enemy shots. Can be used every several seconds.

Stop Watch

(Stopwatch)
How to unlock: Donate 999 pennies.
What it does: Time is slowed down. All enemies and projectiles are slower and the music is slowed down as well.

Challenge Unlocks

To unlock these items, you must beat specific challenges.

Epic Fetus

How to get: Complete "The Family Man" challenge.
What it does: Your tears are replaced with guided missiles that deal massive damage. However, it is absolutely mandatory that you note that this is not a won run yet.

SMB Super Fan!

How to get: Complete "It's In The Cards" challenge.
What it does: Increases all of your stats and restores you to full health.

Death's Touch

How to get: Complete "Waka Waka" challenge.
What it does: Gives you piercing tears, increases your damage and makes your tears look like Death's scythes.

Tech.5

How to get: Complete "The Host" challenge.
What it does: Gives you a laser which fires alongside your existing tears.

Robo Baby 2.0

How to get: Complete "Computer Savvy" challenge.
What it does: Gives you a familiar that you can control with arrow keys. When enemies are in range, it will automatically shoot lasers towards them.

Boss Rush Unlocks

If you defeat Mom under 20 minutes, you will be allowed to proceed to a Boss Rush mode. During that mode, you will be able to choose between four items in exchange for having to fight 15 waves of bosses. Once you finish all waves, you will be given another, random item. Passing the Boss Rush mode with some characters will unlock an item.

Azazel: The Nail

Active item. Grants player extra damage, ability to destroy rocks and extra speed for a room, as well as a single soul heart. Usable every six rooms.

Blue Baby: ???'s Only Friend

Passive item. You gain a controllable follower (similar to Ludovico Technique) which deals damage to enemies on contact.

Cain: Cain's Other Eye

Passive item. Gives you a familiar which bounces around and fires in the same direction as you.

Eden: Undefined

Active item. On use, teleports you to one of the secret rooms, the treasure room or the I Am Error room. Usable every six rooms.

Eve: Eve's Mascara

Passive item. Massively reduces your shot speed, doubles your damage and lowers your rate of fire.

Judas: Judas' Shadow

Passive item. Allows you to respawn as Dark Judas once you die, with higher damage and two black hearts.

Lazarus: Missing No.

Passive item. When picked up and at the start of each floor, randomizes all passive items and stats.

The Lost: D100

Active item. Rerolls pickups, items in the current room, and your current items, but does not reroll itself. Usable every six rooms.

Magdalena: Maggy's Bow

Passive item. Grants you a health up and doubles the amount of healing from red hearts.

Samson: Samson's Chains

Passive item. A flail that blocks shots and allows you to crush rocks and damage enemies with it.

Sheol Unlocks

The Sheol is the first in one of the two final sets of floors which is reachable by descending down a trapdoor after defeating It Lives, or by descending down a trapdoor in the devil room after defeating Mom's Heart. After defeating the boss in the Sheol, some characters will unlock you an item.

Blue Baby: Forget Me Now

Active item. Once used, it will disappear, and you will restart your current floor with a freshly generated set of items, rooms and monsters.

Cain: Bomb Bag

Passive item. Every three rooms, you will receive a bomb drop.

Eden: Book of Secrets

Active item. You will randomly be shown the position of icon rooms on the floor (the compass effect), the map for the floor or the location of secret rooms. Usable every six rooms.

Eve: Razor Blade

Active item. Trade one heart for increased damage for the duration of the room. Unlimited usage.

Isaac: Mom's Knife

Passive item. Your character will now hold a knife which can be thrown after charging it, and which deals massive damage.

The Lost: The Mind

Passive item. Reveals the entire floor including all secret rooms.

Magdalena: Guarding Angel

Passive item. An orbital which doubles the speed of other orbitals, blocks tears and deals damage on contact.

Samson: Blood Rights

Active item. Hurts you for half a heart while damaging other enemies in the room. Unlimited usage.

Cathedral Unlocks

The Cathedral is the second in one of the two final sets of floors which is reachable by standing in the ray of light after defeating It Lives. After defeating the boss in the Cathedral, each character will unlock you an item.

Azazel: Satanic Bible

Active item. Once activated, gives you a black heart. Charges every six rooms.

Blue Baby: D6

Active item. Once activated, it will reroll every item in the current room. Charges every six rooms. After you unlock it, Isaac will use the D6 as his starting item.

Cain: Sack of Pennies

Passive item. Drops a penny or a nickel every two rooms.

Eden: Blank Card

Active item. Once used, it will have the same effect as the rune or the tarot card you are currently holding. Charges every 4 rooms.

Isaac: Isaac's Tears

Active item. Once used, it will deal an area-of-effect damage around your character. It charges with every tear you shoot and is ready after 6 tears shot.

Judas: Guillotine

Passive item. Increases your damage. Your head is removed from your body and is now circling around your body, and deals contact damage.

Lazarus: Lazarus' Rags

Passive item. Upon dying, you will resurrect with one heart container and will yield the Anemic item.

The Lost: Isaac's Heart

Passive item. Your body is immune to all damage, however a heart familiar is spawned and if it takes damage, you take damage as well.

Magdalena: The Relic

Passive item. Every five rooms, you gain a soul heart.

Samson: Bloody Lust

Passive item. Damage taken increases your damage output. Resets every floor. (A.K.A. Blood Lust)

Dark Room Unlocks

Dark Room is one of the two final floors of the game, reachable by entering the chest after the Satan fight in Sheol while holding the Negative. After defeating the final boss with some of the characters, you will unlock certain items.

Azazel: Demon Baby

Passive item. A familiar that follows you and shoots at enemies within reach automatically.

Cain: Abel

Passive item. A familiar that mirrors your movements and shoots in the opposite direction.

Eden: Mystery Sack

Passive item. Every two rooms, you will gain a random pickup item.

Lazarus: Pandora's Box

Active item. Once used, you will get either two pickup items, two active or passive items or 20 coins. Can be used only once.

The Lost: The Soul

Passive item. You gain two soul hearts, and repel enemy projectiles.

Chest Unlocks

The Chest is one of the two final floors of the game, reachable by entering the chest after the Isaac fight in the Cathedral while holding the Polaroid. After defeating the final boss with some of the characters, you will unlock certain items.

Azazel: Abaddon

Passive item. You lose all of your red hearts and they're replaced with 6 black hearts instead. In return, your tears can now fear enemies, and you gain increased damage and evil stats.

Blue Baby: Fate

Passive item. You gain the ability to fly and an eternal heart.

Eve: Sacrificial Dagger

Passive item. You gain a dagger orbital, which deals massive damage and blocks tears. A.K.A. Sacrificial Knife.

Isaac: The D20

Active item. Randomly changes all pickups in the room. Usable every 6 rooms.

The Lost: The Body

Passive item. You gain three red hearts.

Magdalena: Celtic Cross

Passive item. After you get hit, you have a 20% chance to activate a protective shield around you that shields you from all damage for 7 seconds.

Advanced Unlocks

These unlocks will require investing dozens of hours into the game.

The Negative

How to get: After killing Mom's Heart for 11 times, a trapdoor to Sheol will become available. To get this item, beat the Sheol five times. Pro tip: If you get a devil room after killing Mom's Heart, you can descend to Sheol by going to the devil room. From there, you will be able to unlock the Negative before killing Mom's Heart for 11 times.
What it does: Enables you to access one of the final floors after fighting Satan in the Sheol (won't work in the Cathedral). When you have half a red heart or less, every time you take damage, every enemy in the room will be damaged.

The Polaroid

How to get: After killing Mom's Heart for 11 times, a beam of light leading to the Cathedral will become available. To get this item, beat the Cathedral five times.
What it does: Enables you to access one of the final floors after fighting Isaac in the Cathedral (won't work in the Sheol). When you have half a red heart or less, you will gain a shield which protects you from all damage for five seconds.

Dad's Key

How to get: After beating the Lamb by finishing a run with the Negative, you will gain the ability to bomb angel statues in Angel Rooms. Once you bomb an angel statue, you will fight one of the angels, and that fight will net you one half of the key. You must do that one more time to gain the other half. Once you have both halves, you will unlock this item and it will appear in future runs.
What it does: Active item. Allows you to open all locked doors, including item rooms, super secret rooms and challenge rooms. Usable every other room.

Godhead

How to get: First, you have to unlock the Lost Character by dying in four consecutive runs as four different characters in four very specific ways, which is an achievement in and of itself. Then, you have to defeat Mom, Boss Rush, the Cathedral boss, the Sheol boss, the Dark Room boss and the Chest boss on hard mode. As The Lost has exactly 0 HP and can not gain health, that means you must do all of that without getting hit once. Good luck!
What it does: Passive item. Damage, tears and range up. Homing shots. Damaging halo on tears. Shot speed down. A choir of a thousand angels descends and grants you eternal glory upon unlocking this item. Okay, I made that last one up.

[Thatslendytubbiesfan34]

bruh debug doesnt and how unlock all char and uh i have rebirth but i cant get rependnce

[shingle]

Will you update this for repentance?

[Sensei Le Roof]

Ipecac is not an acronym, just a word.

[Gavarelli_]

you could just break the game and activate a mod, then quit the game on that screen and it gives you achievements while you can use the console and then you can unlock all this stuff easy, including godhead. ;3

[Harbinger]

i beat mom's heart 6 times to unlock ipecac but it doesn't spawn and the unlocked items says i didn't get it. i still got the achevement though?

[AbMo]

You can unlock Judas' Tongue by beating Satan with Judas. :P

[little creature]

@Jpg77777 unfortunately you'll need to defeat Greedier mode with the lost. At least he can push the button without getting hit, so all you really need to worry about is ultra greedier. Just play again and again and try to get a high tear rate because his defense scales with your damage.

[LawnChair]

it won't let me unlock god head even though ive defeated all the nesasary things does holy mantle have some thing to do with that or do I have to defeat greed mode with him

[Ratless]

it says ive only killed mom 9 times every time now what do i do

[Flaming Doritos]

Where is the Mom's Hearth/It Lives! Hard Mode Unlock?