The Best Passive Items Tier List

S

A

B

C

D

F

S Tier

Sacred Heart, Glitched Crown

A Tier

C Section, Twisted Pair, Godhead, Sacred Orb, Holy Mantle, Mom's Knife, Tech X, Brimstone, Psy Fly, Cricket's Head, Incubus, Magic Mushroom, Mutant Spider, Crown of Light, Jacob's Ladder, Goat Head, Trisagion, A Lump of Coal, Stop Watch, The Wafer, Pyromaniac, The Parasite, Rock Bottom, More Options, Apple!, Revelation, Ceremonial Robes, Athame, Birthright, Technology Zero, Holy Light, Succubus, 20/20, Cricket's Body, The Stairway, Binge Eater, Polyphemus, Chaos, Pluto, Spoon Bender, Dead Eye, 8 Inch Nails, Ghost Pepper, Little Horn (Item), The Mark, Fire Mind, Host Hat, Gnawed Leaf, Technology, Immaculate Heart, Haemolacria, Death's Touch, The Pact, Blood of the Martyr, The Mind, Steam Sale, Eye of Belial, Rubber Cement, Abaddon, Money = Power, Backstabber, Dark Matter, Bird's Eye, Head of the Keeper, Binky, Tractor Beam, Lusty Blood, Sausage

B Tier

Spirit Sword, Tough Love, Ocular Rift, Soy Milk, The Small Rock, The Halo, Explosivo, Tech.5, SMB Super Fan, Eden's Blessing, Holy Grail, Stigmata, Black Candle, Pentagram, Growth Hormones, Technology 2, Daddy Longlegs, Rotten Baby, Cat-O-Nine-Tails, Duality, Guppy's Tail, Capricorn, The Battery, Guppy's Eye, Dead Cat, Knockout Drops, Fruit Cake, Dead Dove, Maw of the Void, Eucharist, Lachryphagy, Dogma (Item), Squeezy, Paschal Candle, Monstro's Lung, Tooth Picks, Eve's Mascara, Wire Coat Hanger, Almond Milk, YO LISTEN!, Blue Map, Placenta, Star of Bethlehem, Rosary, Champion Belt, Uranus, Terra, Fate, Cancer, Ipecac, Red Stew, PJs, Lodestone, Member Card, Lost Contact, Car Battery, Blanket, Mucormycosis, 4.5 Volt, Voodoo Head, Lord of the Pit, Libra, Purity, Sharp Plug, Toxic Shock, Angelic Prism, Saturnus, The Soul, The Inner Eye, Proptosis, The Sad Onion, The Ludovico Technique, Habit, Stapler, 9 Volt, Restock, Spider Mod, Dog Tooth, Euthanasia, Monstrance, Mom's Contacts, Whore of Babylon, Humbleing Bundle, Sulfuric Acid, Mr. Dolly, Roid Rage, Eye of the Occult, Lead Pencil, Sagittarius, Playdough Cookie, A Dollar, Sacrificial Dagger, Act of Contrition, Worm Friend, Scapular, 7 Seals, Mom's Pearls, Infamy, Odd Mushroom (Large), My Reflection, Tarot Cloth, Continuum, Spirit of the Night, Guppy's Collar, Flat Stone, Neptunus, Treasure Map, Infestation 2, Jumper Cables, 1up!, Bot Fly, Serpent's Kiss, Pisces, Tropicamide, Salvation, Blue Cap, Dark Bum, Trinity Shield, Sinus Infection, Freezer Baby, Pyro, Charged Baby, Mom's Key, Gimpy, Contagion, BFFS!, Leech, Synthoil, Charm of the Vampire, Chocolate Milk, The Body, Compound Fracture, Seraphim, Epic Fetus, Scorpio, Dr. Fetus, There's Options, Sack Head, A Bar of Soap, PHD, X-Ray Vision, Censer, Ouija Board, Keeper's Sack, 3 Dollar Bill, Astral Projection, Transcendence, Black Lotus, Mysterious Liquid, Marbles, Options?, Camo Undies, Dead Onion, Eye Drops

C Tier

Lucky Foot, Torn Photo, The Intruder, Lil Abaddon, Lil Dumpy, Mitre, Schoolbag, Speed Ball, Cambion Conception, Blood Bag, Rune Bag, Lil Brimstone, Parasitoid, Echo Chamber, The Mulligan, Mom's Perfume, Consolation Prize, Rotten Tomato, Judas' Shadow, Bloody Lust, Skeleton Key, Dad's Ring, Divine Intervention, Magic 8 Ball, Cupid's Arrow, Sissy Longlegs, Pop!, Multidimensional Baby, Cube of Meat, Glass Eye, Fanny Pack, Odd Mushroom (Thin), Magic Scab, Adrenaline, Mini Mush, Jesus Juice, Analog Stick, Pupula Duplex, The Polaroid, Orphan Socks, Mars, Papa Fly, Quints, 120 Volt, Divorce Papers, Mom's Purse, Kidney Stone, Scatter Bombs, False PHD, Gemini (Item), Cone Head, The Relic, Tiny Planet, Virgo, Ghost Bombs, Aquarius, Dry Baby, Holy Water, Iron Bar, Metal Plate, Spider Bite, Tooth and Nail, Screw, Mom's Eye, Hallowed Ground, Contract From Below, Luna, Azazel's Rage, Loki's Horns, Deep Pockets, Chemical Peel, MEAT!, Glitter Bombs, Little Steven, Old Bandage, Big Fan, Midas' Touch, Starter Deck, The Compass, Hungry Soul, Caffeine Pill, Raw Liver, Taurus, Sticky Bombs, Dad's Lost Coin, Montezuma's Revenge, Broken Modem, The Common Cold, Purgatory, Mom's Ring, Redemption, Spear of Destiny, Spelunker Hat, Bozo, Lil Monstro, Greed's Gullet, Vanishing Twin, Maggy's Bow, Boom!, Immaculate Conception, Marrow, Lil Portal, Soul Locket, Brother Bobby, Rainbow Baby, Smart Fly, Empty Vessel, Buddy in a Box, Inner Child, Guppy's Hair Ball, Skatole, Anemic, Safety Pin, Lil Loki, Ankh, Card Reading, Evil Charm, Zodiac, Isaac's Tomb, Acid Baby, Brittle Bones, Bogo Bombs, Eye of Greed, Evil Eye, Breakfast, Number One, Lunch, Belly Button, Dark Prince's Crown, Mercurius, Harlequin Baby, Bomber Boy, Hive Mind, Cain's Other Eye, The Negative, Glyph of Balance, No. 2, Rocket in a Jar, Sol, Blood Clot, Spiderbaby, The Swarm, Butt Bombs, Spirit Shackles, Varicose Veins, Robo-Baby, Steven (Item), Sack of Pennies, Halo of Flies, Distant Admiration, Stem Cells, Mongo Baby, Bloody Gust, The Ladder, Epiphora, ???'s Only Friend, Stye, King Baby

D Tier

Robo-Baby 2.0, BBF, Super Bandage, Venus, Dream Catcher, The Peeper, Sworn Protector, Latch Key, Finger!, Mystery Sack, Giant Cell, Boiled Baby, Death's List, Celtic Cross, Little C.H.A.D., Box, Cracked Orb, Large Zit, Vengeful Spirit, Mr. Mega, Black Powder, Experimental Treatment, My Shadow, Thunder Thighs, Sad Bombs, The Virus, Circle of Protection, Bloodshot Eye, A Quarter, Cube Baby, Lil Gurdy, Lost Soul, Dead Bird, Ghost Baby, Mom's Eyeshadow, Sister Maggy, Juicy Sack, Blood Bombs, Belly Jelly, Fast Bombs, Aries, Bob's Curse, Brimstone Bombs, Lil Delirium, Lil Chest, Lil Haunt, Fate's Reward, Sack of Sacks, Bone Spurs, A Pound of Flesh, Key Piece 1, Obsessed Fan, Jaw Bone, Hot Bombs, The Belt, Demon Baby, Bobby-Bomb, 2Spooky, Betrayal, Polydactyly, Match Book, Vasculitis, Wooden Spoon, Night Light, Bum Friend, Mystery Egg, Mom's Lipstick, Bursting Sack, Midnight Snack, Crack Jacks, Ball of Bandages, Glaucoma, Fruity Plum, Lost Fly, Lazarus' Rags, Friend Zone, Pageant Boy, Best Bud, Abel, Mom's Wig, Hypercoagulation, Leo, Little Baggy, Guardian Angel, Hushy, Dead Tooth, Key Bum, Supper, Rotten Meat, Empty Heart, Jupiter, Ball of Tar, Strange Attractor, Sanguine Bond, E. Coli, Pointy Rib, Broken Watch, Pay to Play, Bob's Brain, Infestation, Shade, Mom's Razor, Headless Baby, Booster Pack (Item), Piggy Bank, Candy Heart, Little Gish, Tinytoma, Bucket of Lard, Bomb Bag, Cursed Eye, Dad's Note, Eye Sore, Missing Page 2, Anti-Gravity, Akeldama, Mom's Underwear, Samson's Chains, God's Flesh, Guillotine, Missing No., Depression, Dinner, Mom's Coin Purse, Strawman, A Snack, Dessert, Bird Cage, Key Piece 2, Battery Pack, Dirty Mind, TMTRAINER, Hemoptysis, Blood Oath, Isaac's Heart, Forever Alone, Magneto, <3, Angry Fly, Punching Bag, Poke Go, Linger Bean, Nancy Bombs, Heartbreak, It Hurts, Milk!, IBS, GB Bug, Slipped Rib, Lil Spewer, Leprosy, Mom's Heels, Tonsil, The Wiz, Blood Puppy, Knife Piece 2, Marked, Little Chubby, Farting Baby, Big Chubby, Shard of Glass

F Tier

Knife Piece 1, Curse of the Tower, Keeper's Kin, The Black Bean, Bumbo