The Best Activated Items Tier List

S

A

B

C

D

F

S Tier

Death Certificate

A Tier

R Key, The D6, Spindown Dice, D Infinity, Red Key, Diplopia, Eternal D6, Mega Mush, Mystery Gift, Flip, Book of Virtues, Bag of Crafting, Mama Mega!, Forget Me Now, Damocles, Lemegeton, Book of Shadows, Book of Revelations

B Tier

We Need to Go Deeper!, Dark Arts, Genesis, Sulfur, Satanic Bible, Guppy's Paw, Coupon, Eden's Soul, Blank Card, Void, Sacrificial Altar, Urn of Souls, Crystal Ball, Gello, White Pony, Yum Heart, Abyss, Mr. ME!, Alabaster Box, Guppy's Head, Mega Blast, Black Hole, Prayer Card, D20, The Book of Belial, Book of the Dead, The Bible, Book of Secrets, Stitches, Crooked Penny, Box of Friends, A Pony, The Nail, Pandora's Box, Telepathy for Dummies

C Tier

Clear Rune, Shoop Da Whoop!, Smelter, Anima Sola, Dad's Key, Suplex!, Tammy's Head, Magic Skin, Deck of Cards, D100, Glowing Hourglass, Moving Box, The Candle, Everything Jar, D1, Recall, Monster Manual, Larynx, Notched Axe, Wooden Nickel, Magic Fingers, My Little Unicorn, Head of Krampus, The Book of Sin, Potato Peeler, Telekinesis, Berserk!, The Gamekid, Box of Spiders, D4, Plum Flute, Placebo, Sumptorium, Friendly Ball, Vade Retro, Crack the Sky, Fortune Cookie, The Necronomicon, IV Bag, Glass Cannon, Isaac's Tears, Mom's Box, Decap Attack, Red Candle, Teleport 2.0, Eraser, Ventricle Razor, Converter, Sharp Straw

D Tier

Mom's Bottle of Pills, Undefined, Dull Razor, Doctor's Remote, How to Jump, The Boomerang, Esau Jr., Mine Crafter, Keeper's Box, Flush!, The Pinking Shears, Plan C, The Hourglass, Jar of Wisps, Mom's Bracelet, Mr. Boom, Unicorn Stump, Wavy Cap, Scissors, D8, Friend Finder, Breath of Life, Portable Slot, Metronome, Teleport!, Sprinkler, D7, Delirious, Spider Butt, Dead Sea Scrolls, Lemon Mishap, Yuck Heart, Mom's Bra, Razor Blade, Blood Rights, Meat Cleaver, Wait What?, Kamikaze!, Clicker, Monstro's Tooth, The Poop, Hold, Free Lemonade, Remote Detonator, Dataminer, Brown Nugget, Bob's Rotten Head, Best Friend, Mega Bean, Tear Detonator, The Jar, Anarchist Cookbook, D10, Pause, Sharp Key, Mom's Shovel, Golden Razor, Jar of Flies, Spin to Win, The Bean, Compost

F Tier

Broken Shovel, The Scooper, Kidney Bean, D12, Butter Bean, Broken Glass Cannon, Mom's Pad