Hearts are Pick Ups that replenish Isaac's health. If Isaac runs out of both Red and Soul Hearts he will die and view his Last Will, unless he has Dead Cat, Ankh or 1UP.

If Isaac enters a room with a half Red Heart or less, a pool of urine (blood in Eve's case) will be formed under him.

Red HeartsModifier

Double heart Full heart Half heart

Red Hearts are the most common type of Heart and can be obtained from a large variety of sources, including having an initial 9/10 chance to replace any nonspecific Heart drop. They are divided into Half Hearts and Full Hearts, both of which have an equal chance of spawning once the game has determined that it will spawn a Red Heart. Half Hearts heal Isaac for half of a Heart Container, while Full Hearts heal an entire Container.

Heart ContainersModifier

In order for Isaac to pick up Red Hearts, he must have Heart Containers that can be gained from a number of "Health Up" collectables or through completion of an Eternal Heart. Most characters also begin the game with at least one Heart Container, with the exception of ???, who is unable to gain Heart Containers at all, instead converting them into single Soul Hearts. Upon taking damage, Isaac will lose Red Hearts and be left with unfilled Heart Containers, which can then be refilled by the collection of Red Hearts. Any additional Heart Containers past the visible twelve will be unable to contain Red Hearts, and have limited use.

Heart Containers can be lost from the use of a Health Down Pill, certain Collectables, or being traded to the Devil.

Soul HeartsModifier

Soul heart Half Soul heart

Soul Hearts look similar to regular hearts but are blue with a faint white outline. They are a rarer form of Heart which may replace nonspecific appear instead of Red Hearts, or can be found in Shops. They have a high chance of spawning when a Tinted Rock is blown up.

Soul Hearts function as a form of armor for Isaac, absorbing damage that he takes so that he does not lose any Red Hearts. Once a Soul Heart is obtained, most damage removes Soul Hearts until their supply is depleted. Each Soul Heart adds a full Heart and can take a full Heart's worth of damage before being lost. Soul Hearts may be increased beyond the maximum visible level of Red Hearts and will still be counted even though they are not shown. The last half Soul Heart Isaac has will absorb any amount of damage while breaking, so taking a full Heart of damage with one half Soul Heart will not affect Isaac's Red Hearts.

Additionally, three Soul Hearts may occasionally be traded in the Devil Room in exchange for a Collectable.

A Heart has a chance of spawning as a Soul Heart based on these rules:

  1. 1/10 chance
  2. 1/6 chance if playing as Eve (16.25%)
  3. 1/10 if holding the Mom's Pearl trinket
  4. 1/2 if holding the Mitre

Note that the extra chances for a Soul Heart to spawn are consecutive rather than additive, so (if not Eve) with Mom's Pearl, Isaac's chance would be 1 - (0.9 * 0.9) = 19% (rather than 20%) and with the Mitre his chance would be 1 - (0.9*0.5) = 55% (rather than 60%).

Eternal HeartsModifier


Eternal Hearts are a type of Heart introduced in Wrath of the Lamb. They act as a Half Red Heart until Isaac picks up a second one or moves onto the next floor (also works when the Forget Me Now is used), in which case it will turn into a filled Heart Container. Eternal Hearts alone are not enough to prevent death. If Isaac has an Eternal Heart but no Red Hearts, he will still die if he loses all of his Soul Hearts. However, the Eternal Heart will remain if Isaac comes back to life with Dead Cat, Ankh or 1UP.

Eternal Hearts can replace nonspecific Heart Drops with a 1/50 chance or be granted by obtaining certain Collectable Items. They can also be found in the Cathedral-themed Super Secret Room. In addition, any nonspecific Hearts Spawned in that room will be Eternal.

It is possible to lose Eternal Hearts by getting hurt by enemies and Blood Donation Machines (including IV Bag). Blood Donation Machines take Eternal Hearts before any other type of hearts, but getting hurt by an enemy takes Soul Hearts first, then Eternal Hearts then Red Hearts. Unlike Soul Hearts, taking a full Heart of damage with just an Eternal Heart and Red Hearts will remove the Eternal Heart and half of a Red Heart, not just the Eternal Heart.

If you go into a Devil Room with no soul hearts and an Eternal Heart, and take a deal with the devil that doesn't kill you, you will lose the eternal heart.

Magneto will only attract Eternal Hearts when Isaac has unfilled Heart Containers.

Black HeartsModifier

Black heart Half Black heart

Black Hearts (?) are a type of Heart introduced in Rebirth. They appear in-game as darker colored regular Hearts. The Black Hearts (?) act as a Soul Heart until Isaac receives two (2) half-heart damage, which then summons the Necronomicon effect, and deals damage to all enemies that are in the room. Black Hearts can be found in a Devil Room, Curse Rooms in Red Chests and uncommonly in normal rooms.

(More info is needed)

Finding HeartsModifier

Nonspecific HeartsModifier

These Hearts have a chance to be Red, Soul or Eternal.

Red HeartsModifier

Items That Spawn ThemModifier

Items That Give ThemModifier


Soul HeartsModifier

Items That Spawn ThemModifier

Items That Give ThemModifier


  • 1 — Shop

Eternal HeartsModifier

Items That Give ThemModifier


  • 1 — Cathedral-themed Super Secret Room


Related AchievementsModifier


"Maggy's Wig" - Have seven or more Heart Containers at once in a single playthrough.