The Best Quality 4 Items Tier List
A list of all quality 4 items from The Binding of Isaac: Rebirth, ranked from best to worst.
We combined votes from 79 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.
Rankings updated August 22, 2025.
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