The Best Activated Items Tier List

S

A

B

C

D

F

S Tier

Death Certificate

A Tier

R Key, The D6, Spindown Dice, D Infinity, Red Key, Diplopia, Eternal D6, Mystery Gift, Mega Mush, Mama Mega!, Flip, Bag of Crafting, Book of Virtues, Forget Me Now, Damocles, Lemegeton, Book of Shadows, Book of Revelations

B Tier

We Need to Go Deeper!, Dark Arts, Genesis, Sulfur, Satanic Bible, Guppy's Paw, Coupon, Blank Card, Sacrificial Altar, Eden's Soul, Mr. ME!, Void, Crystal Ball, Gello, White Pony, Urn of Souls, Yum Heart, Alabaster Box, Abyss, Guppy's Head, Black Hole, Crooked Penny, Mega Blast, D20, The Book of Belial, Prayer Card, Book of the Dead, Book of Secrets, Box of Friends, Stitches, The Bible, A Pony, Smelter, The Nail, Pandora's Box, Telepathy for Dummies, Magic Skin, Deck of Cards, Tammy's Head, Clear Rune, Moving Box, Glowing Hourglass, Shoop Da Whoop!, Anima Sola, Suplex!

C Tier

D100, The Candle, Dad's Key, Everything Jar, D1, Recall, Larynx, Monster Manual, Berserk!, Potato Peeler, Wooden Nickel, Notched Axe, Head of Krampus, My Little Unicorn, The Book of Sin, Telekinesis, D4, Placebo, The Gamekid, Friendly Ball, Plum Flute, Sumptorium, Mom's Box, Box of Spiders, Teleport 2.0, Crack the Sky, Magic Fingers, Glass Cannon, Vade Retro, Keeper's Box, Fortune Cookie, The Necronomicon, IV Bag, Eraser, Isaac's Tears, Ventricle Razor, The Boomerang, Converter, Dull Razor, Decap Attack, Mom's Bottle of Pills, Sharp Straw, Undefined, Doctor's Remote, How to Jump, Esau Jr., Mine Crafter, Red Candle, The Pinking Shears, Flush!, The Hourglass, Unicorn Stump

D Tier

Mr. Boom, Wavy Cap, D8, Mom's Bracelet, Scissors, Plan C, Jar of Wisps, Portable Slot, Metronome, Breath of Life, Teleport!, Friend Finder, D7, Sprinkler, Spider Butt, Lemon Mishap, Mom's Bra, Delirious, Meat Cleaver, Wait What?, Yuck Heart, Razor Blade, Dead Sea Scrolls, Kamikaze!, Clicker, Blood Rights, Monstro's Tooth, The Poop, Hold, Free Lemonade, Dataminer, Brown Nugget, Remote Detonator, Bob's Rotten Head, Best Friend, Mega Bean, Sharp Key, Tear Detonator, Anarchist Cookbook, D10, Pause, Mom's Shovel, Golden Razor, Spin to Win, The Jar, The Bean, Jar of Flies, Compost, The Scooper, Kidney Bean, Broken Shovel, D12, Butter Bean, Broken Glass Cannon

F Tier

Mom's Pad