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, The Parasite, Pyromaniac, Rock Bottom, More Options, Apple!, Revelation, Ceremonial Robes, Athame, Birthright, Holy Light, Technology Zero, Succubus, 20/20, The Stairway, Binge Eater, Chaos, Polyphemus, Cricket's Body, Pluto, Spoon Bender, Dead Eye, 8 Inch Nails, Little Horn (Item), Ghost Pepper, Fire Mind, The Mark, Host Hat, Gnawed Leaf, Haemolacria, Immaculate Heart, Technology, Death's Touch, Blood of the Martyr, The Mind, Eye of Belial, Steam Sale, Abaddon, Rubber Cement, The Pact, Money = Power, Backstabber, Dark Matter, Bird's Eye, Head of the Keeper, Tractor Beam, Binky, Lusty Blood, Sausage

B Tier

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

C Tier

Lucky Foot, Torn Photo, The Intruder, Speed Ball, Lil Dumpy, Mitre, Schoolbag, Cambion Conception, Blood Bag, Parasitoid, Rune Bag, Lil Abaddon, Lil Brimstone, Echo Chamber, The Mulligan, Mom's Perfume, Consolation Prize, Rotten Tomato, Judas' Shadow, Bloody Lust, Skeleton Key, Dad's Ring, Divine Intervention, Sissy Longlegs, Magic 8 Ball, Cupid's Arrow, 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, Tooth and Nail, Iron Bar, Metal Plate, Spider Bite, 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, Lil Monstro, Spelunker Hat, Bozo, 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, Lil Loki, Anemic, Safety Pin, Ankh, Zodiac, Card Reading, Evil Charm, 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, King Baby, ???'s Only Friend, Stye

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, Key Bum, Dead Tooth, 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