The Binding of Isaac Quality 4 Items Tier List

39 Items

3.4K Votes

108 Voters

57%Consensus

Updated 2/18/26

A list of all quality 4 items from The Binding of Isaac: Rebirth, ranked from best to worst.

We combined votes from 108 players to create this list.

Based on the latest version of The Binding of Isaac: Repentance.

Quality is the game's internal tier list for items. Quality 4

is the highest tier, so these items are typically the most

powerful.

Sort by

Filter by

S

A

B

C

D

F