The Best Secret Room Items Tier List

S

A

B

C

D

F

S Tier

Death Certificate

A Tier

Glitched Crown, Red Key, Eternal D6, Rock Bottom, Chaos, Sausage

B Tier

Sacred Orb, R Key, Spindown Dice, Lost Contact, 1up!, D Infinity, Infamy, Forget Me Now, Blank Card, Pyro, Echo Chamber, Astral Projection, Dad's Ring, Odd Mushroom (Large), We Need to Go Deeper!

C Tier

Transcendence, Keeper's Sack, Black Lotus, Sack Head, Skeleton Key, Rune Bag, Evil Charm, Odd Mushroom (Thin), Book of Secrets, Vanishing Twin, Orphan Socks, Raw Liver, Sack of Pennies, Greed's Gullet, Isaac's Tomb, Mystery Sack, Inner Child, Binge Eater, Eye of Greed, Lost Soul, A Quarter, Cracked Orb, Mega Mush, Spirit Shackles

D Tier

Mr. Mega, Clear Rune, Flip, Cursed Eye, Sack of Sacks, Wavy Cap, Epic Fetus, Placebo, Missing No., Key Bum, Keeper's Box, TMTRAINER, Strawman, Samson's Chains, Esau Jr., The Necronomicon, GB Bug, Missing Page 2, Compost, Bomb Bag

F Tier

Keeper's Kin