The Most Essential Items In The Binding of Isaac: Afterbirth+

With over 600 items, The Binding of Isaac has ballooned to titanic proportions. Amongst the mountain of unlockables, which should you get first?

The Binding of Isaac is a hard game, and it only gets harder as you unlock tougher and tougher final bosses. Here’s a list of the most essential unlockable items, so you can have stronger, more consistent runs. Have a happy descent! 

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Mom’s Knife

Up first we have one of the game’s best items. Sure to single-handedly carry all but the most terrible of builds, Mom’s Knife is one of the strongest items in the game. To unlock this powerhouse, just defeat Satan when playing as Isaac. Simple. 

Don’t know how to unlock Satan? Check out our guide on how to reach every final boss in Afterbirth+.

Blank Card

The first piece in the most famous game-breaking combo is Blank Card. Unlocked by beating Isaac (in the cathedral) whilst playing as Eden, Blank Card is an active item that will give you the effect of the card you’re holding, without actually consuming the card. This leads to some wild effects if you play your cards right. More about that very soon. 


And here’s part two: Jera. Jera is a rune, a type of consumable that can only be unlocked via completing challenges. Jera is unlocked by completing Challenge #2, High Brow, and will double any consumables that are lying on the ground in the room. The great news is that Blank Card also works for Runes, so you can keep activating it whilst holding a Jera to spawn infinite money, so long as there’s a battery lying on the ground in the room. Needless to say, greed mode becomes completely broken when you perform this loop. Make sure to pick up these items and get to filling that greed donation machine! 


An item that synergises with just about every build, Isaac gets to start with the D6, assuming you take the (admittedly difficult) steps to unlock it. You’ll have to beat Isaac as Blue Baby (otherwise known as ???). The idea of playing a character who can’t pick up red hearts might be daunting, but it’s easier than you think, and if you’ve gotten far enough to (naturally) unlock him, you can certainly pull this off. 

Your reward? An active item that can reroll every pedestal item in the room, doubling your chances at getting Tech X, Brimstone or Mom’s Knife in every item, boss and devil room. It benefits you in greed mode too, doubling your chance to get Blank Card and Jera. 

Chaos Card

Another challenge unlock, the Chaos Card will kill anything in a single hit, including every final boss barring Mega Satan. This incredibly rare drop is essential to have in your item pool, as it will save the worst of runs. Combine this with Blank Card and watch as the game crumbles around you. The challenge you’ll need to beat to unlock Chaos Card is Challenge #9, Demo Man, a very easy task for such an enormous prize. 

Note: you actually have to unlock Demo Man, but follow this list in order, and you’ll unlock it along the way. 

​​Death’s Touch

Death’s Touch is by far the hardest item to unlock on this list, but that’s not without good reason. Complete Challenge #17, Waka Waka, to unlock this hard-carrying, tear-transforming weapon. Waka Waka has a reputation for being one of the harder challenges in the game, and although it’s definitely deserved, its brief length makes it pretty manageable. Banish your standard Isaac tactics, commit to the way of Pac-Man, and you’ll come out with a Scythe machine gun in no time. 

Epic Fetus

My second favourite item in the game (Brimstone is first of course), Epic Fetus is another run-winning powerhouse. Suffer through and complete Challenge #19, Family Man, to unlock this Super Meat Boy inspired missile launcher. The upgrade from violently crying to calling in airstrikes is a big one, and you shouldn’t miss out on the opportunity to blow The Dark Room to pieces. 

What did you think of our list? Are there any more items that should be here? Let us know over on our Twitter!

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