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Welcome to The Binding of Isaac achievement guide. Click on an achievement to learn more.
| 2 new pills | Unlocked a new item. | Complete challenge #25 | 228 |
| Poker Chip | Unlocked a new item. | Complete challenge #26 | 229 |
| Stud Finder | Unlocked a new item. | Complete challenge #27 | 230 |
| D8 | Unlocked a new item. | Complete challenge #28 | 231 |
| Kidney Stone | Unlocked a new item. | Complete challenge #29 (Removed in Afterbirth+ The unlock is bugged and actually unlocks Blank Rune) | 232 |
| Blank Rune | Unlocked a new item. | Complete challenge #30 (Removed in Afterbirth+ The unlock is bugged and actually unlocks Kidney Stone) | 233 |
| Blue Womb | Unlocked a hidden chapter. | Defeat Mom's Heart 10 times | 234 |
| 10.01 | Nerd x 1000000 | Unlock all of the secrets and endings, and collect every item in the game | 235 |
| Keeperholds Wooden Nickel | Unlocked a new starting item. | Defeat Isaac as Keeper | 236 |
| Keeperholds Store Key | Unlocked a new starting item. | Defeat Satan as Keeper | 237 |
| Deep Pockets | Unlocked a new item. | Defeat ??? as Keeper | 238 |
| Karma | Unlocked a new item. | Defeat The Lamb as Keeper | 239 |
| Sticky Nickels | Unlocked a new item. | Complete the Boss Rush as Keeper | 240 |
| Super Greed Baby | Unlocked a new co-player baby. | Defeat Mom's Heart on hard mode as Keeper | 241 |
| Lucky Pennies | Unlocked a new item. | Donate 1 coin to the Greed Machine | 242 |
| Special Hanging Shopkeepers | Unlocked a secret. | Donate 10 coins to the Greed Machine | 243 |
| Wooden Nickel | Unlocked a new item. | Donate 30 coins to the Greed Machine | 244 |
| Cainholds Paperclip | Unlocked a new starting item. | Donate 68 coins to the Greed Machine | 245 |
| Everything is Terrible 2!!! | Greed just got harder! | Donate 111 coins to the Greed Machine | 246 |
| Special Shopkeepers | Unlocked a secret. | Donate 234 coins to the Greed Machine | 247 |
| Eve now holds Razor Blade | Unlocked a new starting item. | Donate 439 coins to the Greed Machine | 248 |
| Store Key | Unlocked a new item. | Donate 666 coins to the Greed Machine | 249 |
| Lostholds Holy Mantle | Unlocked a new starting item. | Donate 879 coins to the Greed Machine | 250 |
| Keeper | Unlocked a new character. | Donate 1000 coins to the Greed Machine | 251 |
| Hive Baby | Unlocked a new co-player baby. | Earn all hard mode completion marks as ??? | 252 |
| Buddy Baby | Unlocked a new co-player baby. | Earn all hard mode completion marks as Isaac | 253 |
| Colorful Baby | Unlocked a new co-player baby. | Earn all hard mode completion marks as Magdalene | 254 |
| Whore Baby | Unlocked a new co-player baby. | Earn all hard mode completion marks as Eve | 255 |
| Cracked Baby | Unlocked a new co-player baby. | Earn all hard mode completion marks as Eden | 256 |
| Dripping Baby | Unlocked a new co-player baby. | Earn all hard mode completion marks as Lazarus | 257 |
| Blinding Baby | Unlocked a new co-player baby. | Use Blank Card while holding XIX - The Sun | 258 |
| Sucky Baby | Unlocked a new co-player baby. | Earn all hard mode completion marks as Azazel | 259 |
| Dark Baby | Unlocked a new co-player baby. | Earn all hard mode completion marks as Lilith | 260 |
| Picky Baby | Unlocked a new co-player baby. | Earn all hard mode completion marks as Cain | 261 |
| Revenge Baby | Unlocked a new co-player baby. | Earn all hard mode completion marks as Samson | 262 |
| Belial Baby | Unlocked a new co-player baby. | Earn all hard mode completion marks as Judas | 263 |
| Sale Baby | Unlocked a new co-player baby. | Earn all hard mode completion marks as Keeper | 264 |
| XXXXXXXXL | Unlocked Challenge #21. | Defeat Mom for the 1st time | 265 |
| SPEED! | Unlocked Challenge #22. | Defeat Mom for the 1st time | 266 |
| Blue Bomber | Unlocked Challenge #23. | Destroy 10 tinted rocks and defeat Mom's Heart 11 times | 267 |
| PAY TO PLAY | Unlocked Challenge #24. | Defeat Isaac as Cain | 268 |
| Have a Heart | Unlocked Challenge #25. | Defeat Mom for the 1st time | 269 |
| I RULE! | Unlocked Challenge #26. | Defeat ??? or The Lamb for the 1st time, and defeat Satan as Isaac | 270 |
| BRAINS! | Unlocked Challenge #27. | Defeat Isaac 5 times | 271 |
| PRIDE DAY! | Unlocked Challenge #28. | Defeat Mom for the 1st time | 272 |
| Onan's Streak | Unlocked Challenge #29. | Defeat Mom for the 1st time | 273 |
| The Guardian | Unlocked Challenge #30. | Defeat Mom for the 1st time | 274 |
| Generosity | If only everyone was as generous as you are... | Donate 999 coins to the Greed Machine | 275 |
| Mega | Unlocked... | Defeat Mega Satan as every character | 276 |
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