The Best Passive Items Tier List

S

A

B

C

D

F

S Tier

Sacred Heart, Mutant Spider, Glitched Crown, A Lump of Coal, Jacob's Ladder

A Tier

Trisagion, More Options, Apple!, Holy Light, Technology Zero, The Parasite, Rock Bottom, C Section, Goat Head, Ceremonial Robes, Twisted Pair, Dead Eye, Godhead, Chaos, Sacred Orb, Birthright, Athame, Host Hat, Pluto, Head of the Keeper, Cricket's Body, Ghost Pepper, Holy Mantle, Gnawed Leaf, Fire Mind, Succubus, Mom's Knife, 8 Inch Nails, Explosivo, Spoon Bender, The Stairway, The Small Rock, Binky, Rubber Cement, Immaculate Heart, Technology, The Mark, Tech.5, Bird's Eye, Mucormycosis, Black Candle, Steam Sale, The Mind, Tractor Beam, SMB Super Fan, Cat-O-Nine-Tails, Growth Hormones, Placenta, Abaddon, Death's Touch, The Battery, Blood of the Martyr, Wire Coat Hanger, Soy Milk, Technology 2, Eden's Blessing, Blue Map, Daddy Longlegs, Cancer, Dark Matter, Tough Love, Eucharist, Eye of Belial, Almond Milk, Tech X, Knockout Drops

B Tier

The Pact, Stigmata, Sausage, Guppy's Tail, Money = Power, The Halo, Backstabber, YO LISTEN!, Little Horn (Item), Tooth Picks, Champion Belt, Lodestone, Rosary, Holy Grail, PJs, Fruit Cake, Capricorn, Libra, Squeezy, Spirit Sword, Pentagram, Maw of the Void, Lost Contact, Member Card, Monstro's Lung, Ocular Rift, Dead Dove, Red Stew, Guppy's Eye, Duality, Eve's Mascara, The Soul, Car Battery, Brimstone, Paschal Candle, Proptosis, Roid Rage, Lachryphagy, Lusty Blood, Infamy, Mom's Contacts, Mom's Pearls, Dogma (Item), Euthanasia, Playdough Cookie, The Inner Eye, Continuum, Blanket, Tarot Cloth, Toxic Shock, Voodoo Head, Gimpy, Tropicamide, Sharp Plug, Spider Mod, Lead Pencil, My Reflection, Star of Bethlehem, Saturnus, Sagittarius, The Sad Onion, Sinus Infection, Treasure Map, 1up!, Psy Fly, Habit, Pyro, Restock, Scapular, Angelic Prism, Humbleing Bundle, The Ludovico Technique, Mr. Dolly, Fate, Rotten Baby, A Dollar, Dead Cat, Chocolate Milk, Bot Fly, The Intruder, Jumper Cables, Synthoil, Cricket's Head, Uranus, Dog Tooth, Lord of the Pit, Scorpio, Contagion, Terra, Mom's Key, Incubus, Flat Stone, Monstrance, Sulfuric Acid, Purity, Odd Mushroom (Large), Magic Mushroom, Astral Projection, 4.5 Volt, Stapler, Dark Bum, Lucky Foot, Leech, Black Lotus, Dad's Ring, Eye Drops, 9 Volt, Mom's Perfume, Crown of Light, Serpent's Kiss, Echo Chamber, Salvation, Transcendence, Guppy's Collar, A Bar of Soap, Mysterious Liquid, Seraphim, Trinity Shield, Ouija Board, X-Ray Vision, Whore of Babylon, Pisces, Sacrificial Dagger, Torn Photo, 7 Seals, Neptunus, Blue Cap, Act of Contrition, Blood Bag, 3 Dollar Bill, Worm Friend, Eye of the Occult, Infestation 2, BFFS!, Fanny Pack, Pupula Duplex, Lil Dumpy, Keeper's Sack, Spirit of the Night, Divorce Papers, Charged Baby, Marbles, Mitre, Pop!, Glass Eye, PHD, Censer, Compound Fracture, Scatter Bombs, Pyromaniac, Stop Watch, Parasitoid, Sack Head, Dead Onion, Analog Stick, The Body, The Wafer, Charm of the Vampire, Camo Undies, Cupid's Arrow, Gemini (Item), Sissy Longlegs, Sticky Bombs

C Tier

Rune Bag, Skeleton Key, The Mulligan, Mom's Eye, Divine Intervention, Rotten Tomato, Tiny Planet, Cambion Conception, Freezer Baby, Mini Mush, Revelation, Cube of Meat, Glitter Bombs, False PHD, Odd Mushroom (Thin), Schoolbag, Metal Plate, Big Fan, Mom's Purse, Bloody Lust, Lil Abaddon, There's Options, Virgo, Kidney Stone, Midas' Touch, Chemical Peel, Adrenaline, Screw, Options?, Magic 8 Ball, Contract From Below, Jesus Juice, Evil Charm, 120 Volt, Azazel's Rage, Dry Baby, Multidimensional Baby, Bozo, Speed Ball, The Polaroid, Loki's Horns, Taurus, Consolation Prize, Ghost Bombs, Lil Brimstone, Holy Water, 20/20, Aquarius, Iron Bar, Binge Eater, Spider Bite, The Relic, Dad's Lost Coin, Mars, Maggy's Bow, Orphan Socks, Polyphemus, Judas' Shadow, The Compass, Vanishing Twin, Little Steven, Anemic, Greed's Gullet, Cone Head, Hungry Soul, Caffeine Pill, Magic Scab, Boom!, Raw Liver, Old Bandage, Broken Modem, Safety Pin, Skatole, Luna, The Common Cold, Sack of Pennies, Soul Locket, Marrow, Card Reading, Brittle Bones, Papa Fly, BBF, Lunch, Deep Pockets, Empty Vessel, Varicose Veins, Brother Bobby, Dark Prince's Crown, Haemolacria, MEAT!, Starter Deck, Number One, Spear of Destiny, Tooth and Nail, Quints, Breakfast, Isaac's Tomb, Bogo Bombs, Epiphora, Spelunker Hat, Smart Fly, Eye of Greed, Guppy's Hair Ball, Acid Baby, Redemption, Blood Clot, Mom's Ring, Lil Portal, Hallowed Ground, The Ladder, Montezuma's Revenge, Belly Button, Evil Eye, The Swarm, Rocket in a Jar, Jaw Bone, Buddy in a Box, Mercurius, Giant Cell, Lost Soul, Thunder Thighs, Immaculate Conception, Inner Child, Halo of Flies, Lil Monstro, Robo-Baby 2.0, Robo-Baby, Juicy Sack, Purgatory, Dream Catcher, Stye, Lil Loki, Hive Mind, Cain's Other Eye, The Negative, Rainbow Baby, Stem Cells, Little C.H.A.D., Sol, Polydactyly, Mystery Sack, Experimental Treatment, Bomber Boy, Black Powder, Butt Bombs, Cracked Orb, Venus, Spiderbaby, Spirit Shackles, Steven (Item), Latch Key, Bob's Curse, Harlequin Baby, No. 2, Distant Admiration, Box, Dead Bird, Boiled Baby, Large Zit, Ankh, Death's List, Sad Bombs, Bobby-Bomb, Zodiac, Key Piece 1, Glaucoma, A Quarter, The Peeper, Mongo Baby, Glyph of Balance, ???'s Only Friend, Bloody Gust, King Baby, Sworn Protector, Finger!, Lazarus' Rags, Bum Friend, Midnight Snack, Cube Baby, Lil Gurdy, The Virus, Sister Maggy, Ipecac, Bursting Sack, Mom's Eyeshadow, The Belt, Obsessed Fan, Aries

D Tier

Mr. Mega, Betrayal, Fate's Reward, Super Bandage, E. Coli, Brimstone Bombs, My Shadow, A Pound of Flesh, Key Bum, Fast Bombs, Demon Baby, Pageant Boy, Bloodshot Eye, Infestation, Little Baggy, Celtic Cross, Vengeful Spirit, Match Book, Hypercoagulation, Epic Fetus, Mom's Wig, Belly Jelly, Mom's Underwear, Mystery Egg, Guardian Angel, Pointy Rib, Night Light, Circle of Protection, Friend Zone, Vasculitis, Guillotine, Isaac's Heart, Lil Haunt, Ghost Baby, Piggy Bank, Blood Bombs, Bob's Brain, Dr. Fetus, 2Spooky, Dead Tooth, Lil Chest, Abel, Mom's Lipstick, Hushy, Cursed Eye, Dad's Note, Sack of Sacks, Samson's Chains, Lil Delirium, Bone Spurs, Fruity Plum, Jupiter, Mom's Coin Purse, Hot Bombs, Supper, Strawman, Rotten Meat, Crack Jacks, Pay to Play, Ball of Tar, Tinytoma, Mom's Razor, Wooden Spoon, Best Bud, Missing No., Missing Page 2, Ball of Bandages, TMTRAINER, Eye Sore, Battery Pack, Booster Pack (Item), Shade, Bucket of Lard, Lil Spewer, Dessert, Empty Heart, Dinner, Lost Fly, Broken Watch, Poke Go, Leo, Candy Heart, Punching Bag, Hemoptysis, IBS, Bird Cage, God's Flesh, Depression, Blood Oath, Heartbreak, Sanguine Bond, GB Bug, Strange Attractor, Key Piece 2, Little Gish, Milk!, Mom's Heels, Linger Bean, Anti-Gravity, It Hurts, Slipped Rib, Headless Baby, Dirty Mind, Forever Alone, Angry Fly, Magneto, Marked, Bomb Bag, <3, Nancy Bombs, Tonsil, Akeldama, Knife Piece 2, Little Chubby, A Snack, The Wiz, Blood Puppy, Leprosy

F Tier

Big Chubby, Farting Baby, Curse of the Tower, Shard of Glass, Knife Piece 1, Bumbo, Keeper's Kin, The Black Bean