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Every Quality 4 Item in The Binding of Isaac

Do you know every single item that is marked as Quality 4 in the The Binding of Isaac?
As of Repentance
Quiz by
Skania56
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Last updated: February 28, 2026
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First submittedFebruary 28, 2026
Times taken62
Average score73.7%
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Description
Type
Item
Double shot
Passive
20/20
All you can eat
Passive
Binge Eater
Blood laser barrage
Passive
Brimstone
It feels cursed
Passive
Broken Shovel (Blade)
It feels cursed
Active
Broken Shovel (Handle)
Fetus shots
Passive
C Section
DMG up
Passive
Cricket's Head
The untainted gain power
Passive
Crown Of Light
Reroll forever
Active
D Infinity
Where am I?
Active
Death Certificate
???
Passive
Dr. Fetus
On-demand air strike
Passive
Epic Fetus
Twist of fate
Active
Flip
?????
Passive
Glitched Crown
God tears
Passive
Godhead
I'm seeing red...
Passive
Haemolacria
Holy shield
Passive
Holy Mantle
Dark friend
Passive
Incubus
Explosive shots
Passive
Ipecac
Description
Type
Item
All stats up!
Passive
Magic Mushroom
Laser breath
Active
Mega Blast
I'm a big boy now!
Active
Mega Mush
Stab stab stab
Passive
Mom's Knife
Lost but not forgotten
Active
Mom's Shovel
Mega tears
Passive
Polyphemus
Flamboyant protector
Passive
Psy Fly
It hurts so good +5 bombs
Passive
Pyromaniac
Time to start over
Active
R Key
Awaken your faith
Passive
Revelation
It's only up from there
Passive
Rock Bottom
Homing shots + DMG up
Passive
Sacred Heart
Destined for greatness
Passive
Sacred Orb
-1
Active
Spindown Dice
Let's slow this down a bit...
Passive
Stop Watch
Laser ring tears
Passive
Tech X
Reroll your destiny
Active
The D6
Damage resistance
Passive
The Wafer
Double trouble!
Passive
Twisted Pair
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