The Binding of Isaac Quality 4 Items Tier List

39 Items

3.2K Votes

101 Voters

Updated January 26, 2026

A list of all quality 4 items from The Binding of Isaac: Rebirth, ranked from best to worst.

We combined votes from 101 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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