The Best Quality 4 Items

A list of all quality 4 items from The Binding of Isaac: Rebirth, ranked from best to worst. We combined votes from 58 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.

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39 Items

1.7K  Votes

58  Voters


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  • 1.Glitched Crown

    Glitched Crown

    1.Glitched Crown

    Passive
    Secret Room
    Quality 4
    44
    100
    Rating
    0.1
    Spread
    44
    100
    Rating
    0.1
    Spread

  • 2.Sacred Heart

    Sacred Heart

    2.Sacred Heart

    Angel Room
    Passive
    Ultra Secret Room
    Quality 4
    44
    96
    Rating
    0.4
    Spread
    44
    96
    Rating
    0.4
    Spread

  • 3.Death Certificate

    Death Certificate

    3.Death Certificate

    Secret Room
    Quality 4
    Activated
    45
    94
    Rating
    0.5
    Spread
    45
    94
    Rating
    0.5
    Spread

  • 4.C Section

    C Section

    4.C Section

    Passive
    Ultra Secret Room
    Treasure Room
    Quality 4
    45
    88
    Rating
    0.2
    Spread
    45
    88
    Rating
    0.2
    Spread

  • 5.Twisted Pair

    Twisted Pair

    5.Twisted Pair

    Passive
    Baby Shop
    Quality 4
    Devil Room
    44
    88
    Rating
    0.3
    Spread
    44
    88
    Rating
    0.3
    Spread

  • 6.The D6

    The D6

    6.The D6

    Ultra Secret Room
    Treasure Room
    Quality 4
    Activated
    Crane Game
    45
    87
    Rating
    0.4
    Spread
    45
    87
    Rating
    0.4
    Spread

  • 7.Mom's Knife

    Mom's Knife

    7.Mom's Knife

    Passive
    Treasure Room
    Old Chest
    Quality 4
    Devil Room
    47
    86
    Rating
    0.3
    Spread
    47
    86
    Rating
    0.3
    Spread

  • 8.Sacred Orb

    Sacred Orb

    8.Sacred Orb

    Angel Room
    Passive
    Secret Room
    Quality 4
    46
    85
    Rating
    0.4
    Spread
    46
    85
    Rating
    0.4
    Spread

  • 9.R Key

    R Key

    9.R Key

    Secret Room
    Quality 4
    Activated
    45
    83
    Rating
    0.5
    Spread
    45
    83
    Rating
    0.5
    Spread

  • 10.Godhead

    Godhead

    10.Godhead

    Angel Room
    Passive
    Quality 4
    45
    82
    Rating
    0.5
    Spread
    45
    82
    Rating
    0.5
    Spread

  • 11.Holy Mantle

    Holy Mantle

    11.Holy Mantle

    Angel Room
    Passive
    Treasure Room
    Quality 4
    44
    82
    Rating
    0.5
    Spread
    44
    82
    Rating
    0.5
    Spread

  • 12.Spindown Dice

    Spindown Dice

    12.Spindown Dice

    Treasure Room
    Secret Room
    Quality 4
    Activated
    Crane Game
    45
    82
    Rating
    0.5
    Spread
    45
    82
    Rating
    0.5
    Spread

  • 13.Tech X

    Tech X

    13.Tech X

    Passive
    Treasure Room
    Quality 4
    Crane Game
    43
    79
    Rating
    0.6
    Spread
    43
    79
    Rating
    0.6
    Spread

  • 14.D Infinity

    D Infinity

    14.D Infinity

    Treasure Room
    Secret Room
    Quality 4
    Activated
    45
    79
    Rating
    0.7
    Spread
    45
    79
    Rating
    0.7
    Spread

  • 15.Brimstone

    Brimstone

    15.Brimstone

    Passive
    Ultra Secret Room
    Quality 4
    Devil Room
    46
    53
    Rating
    0.3
    Spread
    46
    53
    Rating
    0.3
    Spread

  • 16.Cricket's Head

    Cricket's Head

    16.Cricket's Head

    Passive
    Treasure Room
    Quality 4
    Crane Game
    Golden Chest
    46
    51
    Rating
    0.4
    Spread
    46
    51
    Rating
    0.4
    Spread

  • 17.Incubus

    Incubus

    17.Incubus

    Passive
    Baby Shop
    Quality 4
    Devil Room
    46
    51
    Rating
    0.4
    Spread
    46
    51
    Rating
    0.4
    Spread

  • 18.Crown of Light

    Crown of Light

    18.Crown of Light

    Angel Room
    Passive
    Quality 4
    46
    49
    Rating
    0.4
    Spread
    46
    49
    Rating
    0.4
    Spread

  • 19.Psy Fly

    Psy Fly

    19.Psy Fly

    Passive
    Baby Shop
    Treasure Room
    Quality 4
    Key Master
    44
    49
    Rating
    0.5
    Spread
    44
    49
    Rating
    0.5
    Spread

  • 20.Magic Mushroom

    Magic Mushroom

    20.Magic Mushroom

    Passive
    Ultra Secret Room
    Treasure Room
    Quality 4
    Boss
    44
    46
    Rating
    0.4
    Spread
    44
    46
    Rating
    0.4
    Spread

  • 21.Revelation

    Revelation

    21.Revelation

    Angel Room
    Passive
    Quality 4
    41
    44
    Rating
    0.4
    Spread
    41
    44
    Rating
    0.4
    Spread

  • 22.The Wafer

    The Wafer

    22.The Wafer

    Angel Room
    Passive
    Treasure Room
    Quality 4
    46
    43
    Rating
    0.4
    Spread
    46
    43
    Rating
    0.4
    Spread

  • 23.Binge Eater

    Binge Eater

    23.Binge Eater

    Passive
    Secret Room
    Quality 4
    44
    43
    Rating
    0.4
    Spread
    44
    43
    Rating
    0.4
    Spread

  • 24.Mega Mush

    Mega Mush

    24.Mega Mush

    Treasure Room
    Secret Room
    Quality 4
    Activated
    47
    42
    Rating
    0.3
    Spread
    47
    42
    Rating
    0.3
    Spread

  • 25.Pyromaniac

    Pyromaniac

    25.Pyromaniac

    Passive
    Treasure Room
    Quality 4
    45
    41
    Rating
    0.4
    Spread
    45
    41
    Rating
    0.4
    Spread

  • 26.Stop Watch

    Stop Watch

    26.Stop Watch

    Passive
    Quality 4
    Crane Game
    Shop
    44
    41
    Rating
    0.3
    Spread
    44
    41
    Rating
    0.3
    Spread

  • 27.Flip

    Flip

    27.Flip

    Ultra Secret Room
    Secret Room
    Quality 4
    Activated
    Curse Room
    41
    40
    Rating
    0.4
    Spread
    41
    40
    Rating
    0.4
    Spread

  • 28.Polyphemus

    Polyphemus

    28.Polyphemus

    Passive
    Treasure Room
    Quality 4
    42
    23
    Rating
    0.5
    Spread
    42
    23
    Rating
    0.5
    Spread

  • 29.20/20

    20/20

    29.20/20

    Passive
    Treasure Room
    Quality 4
    45
    22
    Rating
    0.5
    Spread
    45
    22
    Rating
    0.5
    Spread

  • 30.Haemolacria

    Haemolacria

    30.Haemolacria

    Passive
    Ultra Secret Room
    Treasure Room
    Quality 4
    44
    22
    Rating
    0.4
    Spread
    44
    22
    Rating
    0.4
    Spread

  • 31.Ipecac

    Ipecac

    31.Ipecac

    Passive
    Treasure Room
    Quality 4
    42
    18
    Rating
    0.4
    Spread
    42
    18
    Rating
    0.4
    Spread

  • 32.Void

    Void

    32.Void

    Angel Room
    Quality 4
    Activated
    Devil Room
    43
    16
    Rating
    0.3
    Spread
    43
    16
    Rating
    0.3
    Spread

  • 33.Satanic Bible

    Satanic Bible

    33.Satanic Bible

    Treasure Room
    Quality 4
    Activated
    Library
    Devil Room
    41
    14
    Rating
    0.3
    Spread
    41
    14
    Rating
    0.3
    Spread

  • 34.Abyss

    Abyss

    34.Abyss

    Ultra Secret Room
    Quality 4
    Activated
    Devil Room
    45
    14
    Rating
    0.2
    Spread
    45
    14
    Rating
    0.2
    Spread

  • 35.Dr. Fetus

    Dr. Fetus

    35.Dr. Fetus

    Passive
    Treasure Room
    Quality 4
    45
    11
    Rating
    0.5
    Spread
    45
    11
    Rating
    0.5
    Spread

  • 36.Epic Fetus

    Epic Fetus

    36.Epic Fetus

    Passive
    Treasure Room
    Secret Room
    Quality 4
    43
    9
    Rating
    0.3
    Spread
    43
    9
    Rating
    0.3
    Spread

  • 37.Mega Blast

    Mega Blast

    37.Mega Blast

    Quality 4
    Activated
    Devil Room
    39
    9
    Rating
    0.4
    Spread
    39
    9
    Rating
    0.4
    Spread

  • 38.Mom's Shovel

    Mom's Shovel

    38.Mom's Shovel

    Quality 4
    Activated
    40
    0
    Rating
    0.1
    Spread
    40
    0
    Rating
    0.1
    Spread

  • 39.Broken Shovel

    Broken Shovel

    39.Broken Shovel

    Quality 4
    Activated
    45
    0
    Rating
    0.1
    Spread
    45
    0
    Rating
    0.1
    Spread

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