A list of all quality 4 items from The Binding of Isaac: Rebirth, ranked from best to worst.
We combined votes from 85 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.
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Death Certificate, Sacred Heart
Glitched Crown, C Section, Twisted Pair, Sacred Orb, Godhead, R Key, Mom's Knife, The D6, Holy Mantle, Spindown Dice
Tech X, D Infinity, Brimstone, Incubus, Cricket's Head, Psy Fly
Magic Mushroom, Crown of Light, The Wafer, Stop Watch, Mega Mush, Pyromaniac, Revelation, Binge Eater, Flip, 20/20, Polyphemus
Haemolacria, Satanic Bible, Ipecac, Void, Dr. Fetus, Abyss, Epic Fetus, Mega Blast
Broken Shovel, Mom's Shovel
