The Best Secret Room Items Tier List

S

A

B

C

D

F

S Tier

Death Certificate, Glitched Crown

A Tier

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

B Tier

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

C Tier

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

D Tier

Sack of Pennies, Spirit Shackles, A Quarter, Mr. Mega, The Necronomicon, Placebo, Sack of Sacks, Bomb Bag, Esau Jr., Wavy Cap, Cursed Eye, Keeper's Box, Key Bum, Missing Page 2, Strawman, GB Bug, TMTRAINER, Samson's Chains, Missing No., Compost

F Tier

Keeper's Kin