The Best Secret Room Items Tier List

S

A

B

C

D

F

S Tier

Death Certificate, Glitched Crown

A Tier

R Key, Sacred Orb, Spindown Dice, Rock Bottom, D Infinity, Red Key, Chaos, Eternal D6

B Tier

Sausage, Mega Mush, Binge Eater, Forget Me Now, Flip, Lost Contact, We Need to Go Deeper!, Infamy, Sack Head, 1up!, Echo Chamber, Rune Bag, Blank Card, Black Lotus, Odd Mushroom (Large), Pyro, Keeper's Sack, Transcendence

C Tier

Epic Fetus, Skeleton Key, Astral Projection, Dad's Ring, Orphan Socks, Odd Mushroom (Thin), Inner Child, Book of Secrets, Mystery Sack, Clear Rune, Lost Soul, Raw Liver, Eye of Greed

D Tier

Mr. Mega, Evil Charm, Isaac's Tomb, Cracked Orb, Vanishing Twin, Sack of Sacks, Sack of Pennies, Spirit Shackles, Keeper's Box, Greed's Gullet, Placebo, A Quarter, The Necronomicon, Key Bum, Cursed Eye, Wavy Cap, Esau Jr., Bomb Bag, Missing Page 2, Strawman

F Tier

Samson's Chains, GB Bug, TMTRAINER, Missing No., Compost, Keeper's Kin