The Binding of Isaac: Rebirth Trinkets, Cards and Runes Guide
Complete reference for trinkets, tarot cards, runes, pills, and consumables in Isaac Rebirth. Learn Cracked Key creation, pill identification, and trinket strategies.
Beyond the 719+ passive and active items, Isaac features an extensive consumable ecosystem: trinkets, tarot cards, runes, pills, cards, and batteries. These smaller modifiers can dramatically alter runs — a Pulled Tooth trinket enables free devil deals, a Joker card guarantees a devil or angel room, and a Cracked Key unlocks Tainted characters on Home. Mastering consumables separates good players from great ones.
Trinkets
Trinkets are passive modifiers that occupy a separate trinket slot. You can hold one trinket at a time (two with Belly Button or Mom's Box). Trinkets can be dropped on the ground and picked up later — a mechanic essential for Tainted character unlocks. Drop a trinket in a boss or treasure room before starting the ascent with Dad's Note, and it transforms into a Cracked Key when you revisit that room. Key trinkets include: Mom's Toenail (Mom's foot stomp attack), Golden Horseshoe (better angel rooms), Store Credit (free shop items), and Walnut (breaks for random rewards).
Tarot Cards and Runes
| Card/Rune | Effect | Strategic Use |
|---|---|---|
| The Fool | Teleports to spawn room | Essential for Mom boss room exit to reach strange door |
| Joker | Opens devil or angel room | Guarantees deals on demand |
| Hierophant | Spawns soul hearts | Survival on devil deal characters |
| Empress | Temporary stat boost | Boss fight burst damage |
| Ansuz | Full floor reveal | Finding secret and super secret rooms |
| Perthro | Rerolls items in room | Rerolling bad treasure items |
| Dagaz | Removes curses + soul heart | Curse floor recovery |
| Algiz | Invincibility | Boss fight safety net |
Pills and Pill Identification
Pills are consumables with randomized effects that persist across runs once identified. PhD guarantees positive pill effects. Virgo converts bad pills to positive. Identified pills show their effect for all future runs on that save file. Important pills include: Balls of Steel (soul heart), Full Health (full heal), Percs (damage reduction for the room), and Amnesia (forgets mapped rooms). In co-op, pill effects are shared across players.
Cracked Key — The Most Important Consumable
The Cracked Key is essential for unlocking all Tainted characters after your first Home visit. Create Cracked Keys by dropping trinkets in boss or treasure rooms before picking up Dad's Note during the ascent. When you revisit those rooms while ascending, the trinket becomes a Cracked Key. Use it on the red door outline near Mom's bedroom on Home to access Tainted character closets. Read our Red Key and Cracked Key guide for the complete walkthrough.
Frequently Asked Questions
How many trinkets are in Isaac Rebirth?
There are over 60 trinkets across all DLC, each providing unique passive effects. Trinkets are held separately from items and can be swapped by dropping and picking up.
What does the Cracked Key do?
The Cracked Key works like the Red Key — it opens red door outlines to access hidden rooms. It is created by dropping trinkets during ascent runs and is required to unlock Tainted characters after your first Home visit.
Do pill effects persist between runs?
Once you use a pill and identify its effect, that pill color is permanently identified for your save file. Future runs with the same pill color will show the effect before consumption.
Can I carry multiple trinkets?
Normally one trinket at a time. Mom's Box doubles trinket effects without adding a slot. Belly Button provides a second trinket slot.
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