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

C Tier

Skeleton Key, Astral Projection, Dad's Ring, Odd Mushroom (Thin), Orphan Socks, Inner Child, Book of Secrets, Mystery Sack, Clear Rune, Lost Soul, Raw Liver, Evil Charm, Eye of Greed, Mr. Mega, Isaac's Tomb, Cracked Orb, Vanishing Twin

D Tier

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

F Tier

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