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Welcome to The Binding of Isaac achievement guide. Click on an achievement to learn more.
| Buddy in a Box | Unlocked a new item. | Pick up 5 familiars in a single run | 355 PS4 346 |
| Fast Bombs | Unlocked a new item. | Defeat Little Horn 20 times | 356 PS4 347 |
| Lil Delirium | Unlocked a new item. | Defeat Delirium for the 1st time | 357 PS4 348 |
| Hairpin | Unlocked a new item. | Recharge using batteries 20 times | 358 PS4 349 |
| Wooden Cross | Unlocked a new item. | Sleep in a bed | 359 PS4 350 |
| Butter! | Unlocked a new item. | Complete 2 Victory Laps and start a 3rd | 360 PS4 351 |
| Huge Growth | Unlocked a new item. | Increase in size 5 times in a single run. Sources of increased size include "One Makes you Larger" pills, XI - Strength, and Magic Mushroom | 361 PS4 352 |
| Ancient Recall | Unlocked a new item. | Use cards and runes 20 times | 362 PS4 353 |
| Era Walk | Unlocked a new item. | Have both the Broken Watch and the Stop Watch in your collection | 363 PS4 354 |
| Coupon | Unlocked a new item. | Purchase from shops 50 times | 364 PS4 355 |
| Telekinesis | Unlocked a new item. | Beat Chapter 2 without taking damage | 365 PS4 356 |
| Moving Box | Unlocked a new item. | Use Pandora's Box in the Dark Room | 366 PS4 357 |
| Jumper Cables | Unlocked a new item. | Pick up any 3 of the following items/trinkets in a single run: 9 Volt, The Battery, Car Battery, AAA Battery, Watch Battery | 367 PS4 358 |
| Leprosy | Unlocked a new item. | Beat Chapter 3 without taking damage | 368 PS4 359 |
| Technology Zero | Unlocked a new item. | Pick up two technology items in one run | 369 PS4 360 |
| Filigree Feather | Unlocked a new item. | Acquire both key pieces | 370 PS4 361 |
| Mr. ME! | Unlocked a new item. | Open 20 locked chests | 371 PS4 362 |
| 7 Seals | Unlocked a new item. | Defeat all 5 Harbingers | 372 PS4 363 |
| Angelic Prism | Unlocked a new item. | Defeat an Angel 10 times | 373 PS4 364 |
| Pop! | Unlocked a new item. | Beat Chapter 4 without taking damage | 374 PS4 365 |
| Door Stop | Unlocked a new item. | Blow up doors and secret room walls 50 times | 375 PS4 366 |
| Death's List | Unlocked a new item. | Take 25 devil deals | 376 |
| Haemolacria | Unlocked a new item. | Acquire Blood Clot 10 times | 377 |
| Lachryphagy | Unlocked a new item. | Collect 10 "tears up" items or pills in one run | 378 |
| Schoolbag | Unlocked a new item. | Enter every shop from Chapter 1 through Chapter 3 in one run | 379 |
| Trisagion | Unlocked a new item. | Take 25 items from Angel rooms | 380 |
| Extension Cord | Unlocked a new item. | Have The Battery, 9 Volt, and Car Battery in your collection | 381 |
| Flat Stone | Unlocked a new item. | Acquire Rubber Cement 5 times | 382 |
| Sacrificial Altar | Unlocked a new item. | Take 50 devil deals | 383 |
| Lil Spewer | Unlocked a new item. | Die to your own explosion from Ipecac, Bob's Rotten Head, or Horf! pill | 384 |
| Blanket | Unlocked a new item. | Sleep in 10 beds | 385 |
| Marbles | Unlocked a new item. | Use 5 Gulp! pills in one run | 386 |
| Mystery Egg | Unlocked a new item. | Spawn three charmed enemies in the same room | 387 |
| Rotten Penny | Unlocked a new item. | Have 20 blue flies at the same time | 388 |
| Baby-Bender | Unlocked a new item. | Use I - The Magician or Telepathy for Dummies while already having homing tears (Sources of this effect include I - The Magician, Telepathy for Dummies, Spoon Bender, Sacred Heart, or Godhead). | 389 |
| The Forgotten | Unlocked a new character. | It's complicated | 390 |
| Bone Heart | Unlocked a new item. | It's complicated | 391 |
| Marrow | Unlocked a new item. | Defeat Mom's Heart or It Lives! on hard modeas The Forgotten | 392 |
| Slipped Rib | Unlocked a new item. | Defeat Isaac as The Forgotten | 393 |
| Pointy Rib | Unlocked a new item. | Defeat Satan as The Forgotten | 394 |
| Jaw Bone | Unlocked a new item. | Defeat ??? as The Forgotten | 395 |
| Brittle Bones | Unlocked a new item. | Defeat The Lamb as The Forgotten | 396 |
| Divorce Papers | Unlocked a new item. | Complete the Boss Rush as The Forgotten | 397 |
| Hallowed Ground | Unlocked a new item. | Defeat Hush as The Forgotten | 398 |
| Finger Bone | Unlocked a new item. | Defeat Ultra Greed as The Forgotten | 399 |
| Dad's Ring | Unlocked a new item. | Defeat Ultra Greedier as The Forgotten | 400 |
| Book of the Dead | Unlocked a new item. | Defeat Delirium as The Forgotten | 401 |
| Bone Baby | Unlocked a new co-player baby. | Earn all Hard Mode Completion Marks as The Forgotten | 402 |
| Bound Baby | Unlocked a new co-player baby. | Defeat Mega Satan as The Forgotten | 403 |
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