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, Sausage, Eternal D6

B Tier

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

C Tier

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

D Tier

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

F Tier

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