A list of all quality 4 items from The Binding of Isaac: Rebirth, ranked from best to worst.
We combined votes from 68 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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Sacred Heart, Death Certificate, Glitched Crown
C Section, Twisted Pair, Sacred Orb, The D6, Mom's Knife, R Key, Godhead, Holy Mantle, Spindown Dice, Tech X, D Infinity
Brimstone, Incubus, Cricket's Head, Magic Mushroom, Psy Fly
The Wafer, Crown of Light, Pyromaniac, Stop Watch, Revelation, Binge Eater, Mega Mush, Flip
20/20, Polyphemus, Haemolacria, Void, Satanic Bible, Ipecac, Abyss, Dr. Fetus, Mega Blast, Epic Fetus
Mom's Shovel, Broken Shovel
