The Best Passive Items Tier List

S

A

B

C

D

F

S Tier

Sacred Heart, Glitched Crown

A Tier

C Section, Twisted Pair, Sacred Orb, Godhead, Holy Mantle, Mom's Knife, Tech X, Brimstone, Psy Fly, Cricket's Head, Incubus, Magic Mushroom, Mutant Spider, Crown of Light, Jacob's Ladder, Goat Head, Trisagion, A Lump of Coal, Stop Watch, The Wafer, The Parasite, Pyromaniac, Rock Bottom, More Options, Apple!, Ceremonial Robes, Revelation, Athame, Birthright, Holy Light, Technology Zero, Succubus, 20/20, Polyphemus, The Stairway, Cricket's Body, Chaos, Binge Eater, Pluto, Spoon Bender, Dead Eye, 8 Inch Nails, Little Horn (Item), Ghost Pepper, Fire Mind, The Mark, Host Hat, Gnawed Leaf, Technology, Immaculate Heart, Death's Touch, Haemolacria, The Mind, Blood of the Martyr, Eye of Belial, Steam Sale, Abaddon, Rubber Cement, The Pact, Tractor Beam, Backstabber, Dark Matter, Bird's Eye, Head of the Keeper, Binky, Lusty Blood, Sausage

B Tier

Spirit Sword, Tough Love, Soy Milk, Ocular Rift, The Small Rock, The Halo, Money = Power, Explosivo, Tech.5, SMB Super Fan, Eden's Blessing, Holy Grail, Stigmata, Black Candle, Pentagram, Growth Hormones, Daddy Longlegs, Technology 2, Rotten Baby, Cat-O-Nine-Tails, Duality, Guppy's Tail, Capricorn, The Battery, Guppy's Eye, Lachryphagy, Dead Cat, Knockout Drops, Maw of the Void, Fruit Cake, Dead Dove, Paschal Candle, Eucharist, Dogma (Item), Squeezy, Wire Coat Hanger, Monstro's Lung, Tooth Picks, Almond Milk, Star of Bethlehem, YO LISTEN!, Blue Map, Placenta, Uranus, Rosary, Champion Belt, Terra, Cancer, Ipecac, Red Stew, PJs, Libra, Lodestone, Fate, Member Card, Lost Contact, Car Battery, Blanket, Mucormycosis, 4.5 Volt, Voodoo Head, Lord of the Pit, Eve's Mascara, Purity, Sharp Plug, Toxic Shock, Saturnus, The Soul, The Inner Eye, Habit, Proptosis, The Sad Onion, The Ludovico Technique, Eye of the Occult, Stapler, Restock, Dog Tooth, Spider Mod, Euthanasia, Monstrance, Mom's Contacts, 9 Volt, Whore of Babylon, Humbleing Bundle, Sulfuric Acid, Mr. Dolly, Roid Rage, Angelic Prism, Sagittarius, Lead Pencil, Infestation 2, Jumper Cables, Playdough Cookie, A Dollar, Sacrificial Dagger, Act of Contrition, Scapular, Odd Mushroom (Large), Infamy, My Reflection, Tarot Cloth, Continuum, Worm Friend, Spirit of the Night, Guppy's Collar, Flat Stone, Treasure Map, 1up!, Synthoil, Bot Fly, Serpent's Kiss, Pisces, Tropicamide, Salvation, Blue Cap, 7 Seals, Seraphim, Dark Bum, Sinus Infection, Trinity Shield, Pyro, Mom's Key, Gimpy, Contagion, X-Ray Vision, A Bar of Soap, Charged Baby, Freezer Baby, Epic Fetus, Leech, BFFS!, Mom's Pearls, Charm of the Vampire, Chocolate Milk, Transcendence, The Body, Compound Fracture, Scorpio, There's Options, Neptunus, Sack Head, Dr. Fetus, PHD, Ouija Board, Keeper's Sack, 3 Dollar Bill, Astral Projection, Censer, Black Lotus, Mysterious Liquid, Marbles, Options?, Camo Undies, Dead Onion, Eye Drops

C Tier

Lucky Foot, Torn Photo, The Intruder, Speed Ball, Lil Dumpy, Schoolbag, Mitre, Cambion Conception, Blood Bag, Pop!, Parasitoid, Rune Bag, Lil Abaddon, The Mulligan, Echo Chamber, Lil Brimstone, Mom's Perfume, Consolation Prize, Rotten Tomato, Judas' Shadow, Bloody Lust, Skeleton Key, Dad's Ring, Sissy Longlegs, Divine Intervention, Magic 8 Ball, Cupid's Arrow, Orphan Socks, Multidimensional Baby, Cube of Meat, Glass Eye, Fanny Pack, Odd Mushroom (Thin), Magic Scab, Adrenaline, Mini Mush, Jesus Juice, Analog Stick, Pupula Duplex, The Polaroid, Mars, Papa Fly, Quints, Chemical Peel, 120 Volt, Divorce Papers, Mom's Purse, Scatter Bombs, False PHD, Gemini (Item), Cone Head, Tiny Planet, The Relic, Virgo, Aquarius, Ghost Bombs, Dry Baby, Holy Water, Iron Bar, Tooth and Nail, Metal Plate, Spider Bite, Screw, Mom's Eye, Hallowed Ground, Kidney Stone, Contract From Below, Luna, Loki's Horns, MEAT!, Glitter Bombs, Little Steven, Old Bandage, Big Fan, Midas' Touch, Starter Deck, The Compass, Hungry Soul, Caffeine Pill, Azazel's Rage, Raw Liver, Sticky Bombs, Taurus, Dad's Lost Coin, Montezuma's Revenge, Broken Modem, Deep Pockets, Purgatory, Mom's Ring, Redemption, Spear of Destiny, Lil Monstro, Spelunker Hat, Breakfast, Greed's Gullet, Bozo, Vanishing Twin, Maggy's Bow, Immaculate Conception, Marrow, Lil Portal, Soul Locket, Brother Bobby, Smart Fly, Rainbow Baby, The Common Cold, Inner Child, Skatole, Lil Loki, Anemic, Ankh, Boom!, Steven (Item), Zodiac, Evil Charm, Isaac's Tomb, Acid Baby, Brittle Bones, Empty Vessel, Bogo Bombs, Eye of Greed, Evil Eye, Number One, Buddy in a Box, Guppy's Hair Ball, Lunch, Belly Button, Dark Prince's Crown, Mercurius, Harlequin Baby, Bomber Boy, Hive Mind, Safety Pin, Cain's Other Eye, The Negative, Card Reading, Glyph of Balance, No. 2, Rocket in a Jar, Sol, Blood Clot, Spiderbaby, The Swarm, Butt Bombs, Varicose Veins, Robo-Baby, Sack of Pennies, Halo of Flies, Distant Admiration, Stem Cells, Mongo Baby, Spirit Shackles, Bloody Gust, The Ladder, Sad Bombs, Epiphora, King Baby, ???'s Only Friend, Stye

D Tier

Super Bandage, Robo-Baby 2.0, BBF, Venus, Dream Catcher, The Peeper, Sworn Protector, Key Piece 1, Latch Key, Mystery Sack, Finger!, Giant Cell, Boiled Baby, Death's List, Little C.H.A.D., Celtic Cross, Box, Cracked Orb, Mr. Mega, Vengeful Spirit, Black Powder, Experimental Treatment, My Shadow, Thunder Thighs, The Virus, Large Zit, Bloodshot Eye, A Quarter, Cube Baby, Lil Gurdy, Lost Soul, Dead Bird, Ghost Baby, Mom's Eyeshadow, Sister Maggy, Juicy Sack, Blood Bombs, Belly Jelly, Fast Bombs, Aries, Circle of Protection, Bob's Curse, Brimstone Bombs, Lil Chest, Lil Delirium, Lil Haunt, Fate's Reward, Bone Spurs, A Pound of Flesh, Obsessed Fan, Jaw Bone, The Belt, Bobby-Bomb, Demon Baby, 2Spooky, Sack of Sacks, Betrayal, Polydactyly, Match Book, Vasculitis, Wooden Spoon, Bum Friend, Mystery Egg, Mom's Lipstick, Bursting Sack, Hot Bombs, Midnight Snack, Crack Jacks, Ball of Bandages, Night Light, Glaucoma, Sanguine Bond, Fruity Plum, Lost Fly, Lazarus' Rags, Friend Zone, Pageant Boy, Abel, God's Flesh, Mom's Wig, Hypercoagulation, Best Bud, Leo, Little Baggy, Anti-Gravity, Guardian Angel, Key Bum, Hushy, Dead Tooth, Empty Heart, Ball of Tar, Supper, Rotten Meat, Strange Attractor, E. Coli, Pointy Rib, Jupiter, Broken Watch, Pay to Play, Bob's Brain, Infestation, Shade, Mom's Razor, Headless Baby, Booster Pack (Item), Piggy Bank, Candy Heart, Little Gish, Tinytoma, Bucket of Lard, Bomb Bag, Cursed Eye, Dad's Note, Missing Page 2, Eye Sore, Akeldama, Samson's Chains, Mom's Underwear, Guillotine, Missing No., Depression, Dinner, Mom's Coin Purse, A Snack, Strawman, Dessert, Bird Cage, Key Piece 2, Battery Pack, TMTRAINER, Hemoptysis, Blood Oath, Dirty Mind, Isaac's Heart, Forever Alone, Magneto, <3, Angry Fly, Punching Bag, Poke Go, Linger Bean, Nancy Bombs, Heartbreak, It Hurts, Milk!, IBS, GB Bug, Slipped Rib, Lil Spewer, Leprosy, Mom's Heels, Tonsil, The Wiz, Blood Puppy, Knife Piece 2, Marked, Little Chubby, Farting Baby, Big Chubby, Shard of Glass

F Tier

Knife Piece 1, Curse of the Tower, Keeper's Kin, The Black Bean, Bumbo