The Best Secret Room Items Tier List

S

A

B

C

D

F

S Tier

Death Certificate, Glitched Crown, Red Key

A Tier

Rock Bottom, Chaos, Eternal D6, Sausage, Sacred Orb

B Tier

Spindown Dice, R Key, Blank Card, Echo Chamber, D Infinity, Lost Contact, Rune Bag, Transcendence, Keeper's Box, Infamy, Pyro, Vanishing Twin, Astral Projection, Mystery Sack, Mr. Mega

C Tier

Odd Mushroom (Large), We Need to Go Deeper!, Black Lotus, Raw Liver, Skeleton Key, Dad's Ring, Spirit Shackles, Sack Head, Orphan Socks, Forget Me Now, Sack of Pennies, Keeper's Sack, Isaac's Tomb, Book of Secrets, 1up!, Cracked Orb, Odd Mushroom (Thin), Greed's Gullet, Binge Eater, Evil Charm

D Tier

Mega Mush, Clear Rune, Inner Child, Eye of Greed, Wavy Cap, Sack of Sacks, Flip, Bomb Bag, Cursed Eye, Strawman, Missing No., Placebo, Esau Jr., Epic Fetus, Lost Soul, A Quarter, Samson's Chains, Missing Page 2, Compost

F Tier

GB Bug, The Necronomicon, Key Bum, Keeper's Kin, TMTRAINER