A good item in Isaac can salvage a run. The best items can win a run.

5. Death Certificate

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This item really shouldn’t be on the list, but it is simply because it is technically the literal best item in the game. The Death Certificate takes you to a special floor where you can pick one item that you want. Any item you want in the game save for a special few. By definition, an item that guarantees you the best item in the game is just as good as the best item in the game.

4. Dead Cat

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Dead Cat’s effect is very simple; it gives you nine lives. Since you normally only have the one life, you can abuse your newfound longevity in Demon Rooms to get top-tier items. It’s also a godsend on difficult characters like the Lost, who normally dies in a heartbeat. Just be careful when picking it up; it sets your heart containers to one upon pickup.

Related: How to unlock Downpour in Binding of Isaac Repentance

3. Holy Mantle

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One free hit in every room may not sound like much, but that chip damage easily builds up over time. It also lets you enter and exit curse rooms for free, giving you access to a new source of items and resources for no cost at all.

2. Godhead

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The task of unlocking Godhead is no joke, but once you do, you have one of the single best items in the Isaac of Isaac. A sizable damage up, a damaging holy aura around your tears, and a homing effect—what more could you ask for from a single item?

1. R Key

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Want access to a full run’s worth of shops, item rooms, boss items, Angel and Devil deal chances, and everything else that comes with a run? Want to beat both ??? and the Lamb in the same run? Well, here you go. All it costs you is your Active item and your time. Good luck.

For help with an item that certainly isn’t the best in the game, go check out All Pandora’s Box Effects in The Binding of Isaac on Pro Game Guides!

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