In Afterbirth † and prior, 13 items are considered special and will be less likely to appear if the player has already come across other special items. Repentance added 169 new items, for a total of 716 items. Afterbirth † added 111 new items, for a total of 547 items. Afterbirth added 95 new items, for a total of 436 items. The original The Binding of Isaac had 196 items. Some items are passive, which add an effect permanently to Isaac, while others only activate when used. Items are classified into several distinct types and groups. They modify Isaac's attributes, grant or modify tear effects, and much more. Items are an integral part of the game-play of The Binding of Isaac: Rebirth.
