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, D Infinity, Rock Bottom, Red Key, Chaos, Eternal D6

B Tier

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

C Tier

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

D Tier

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

F Tier

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