A single six-sided die, red in color with black spots indicating the number associated with each side.
Upon activation, any Items in the current room will be 're-rolled' and turned into another item that corresponds with that room's Item Pool. This effect is limited to collectible items, i.e. those which appear on a pedestal, and has no effect on Pick Ups.
For example, if Tammy's Head spawns from a Golden Chest, re-rolling it will result in an item from the Golden Chest Pool. However, if Tammy's Head spawns from a Golden Chest in a Boss Room, re-rolling it will result in an item from the Boss Room Pool instead of one from the Golden Chest Pool.
- As with most Activated Items, Items such as Habit, 9 Volt and The Battery decrease the charge time, increasing the effectiveness of this item. As it recharges in three rooms and very rarely can be used to best effect during combat, 9 Volt would be a strictly better choice than The Battery in most scenarios, unusually, although The Habit is usually most useful when paired with items such as Scapular.
- The Dice can also be used to re-roll shop merchandise (only Collectibles) and offers from the Devil Room or the Angel Room.
- When re-rolling Devil Room items, they retain their cost. You can obtain 2 heart items for 1 heart this way.
- Exhausting the Library item pool with The Dice will cause it to draw from the Treasure Room item pool, essentially making Libraries the equivalent of two Treasure Rooms.
- Using The Dice in a room with no items will do nothing, and the charge will be wasted.
- The Dice will not re-roll alternative boss drops: Steven (item) and Little Steve dropped by Steven (re-rolling can work to exchange these two items, but not exchange other boss items), Little Gish dropped by Gish, Little C.H.A.D. dropped by C.H.A.D., A Pony dropped by the Headless Horseman, Cube Of Meat dropped by The Harbingers, and White Pony dropped by Conquest. However, picking up A Pony or White Pony will allow it to be re-rolled once The Dice is re-obtained.
- If The Dice is used to re-roll an item in the first boss room of an XL floor, it will be re-rolled using the limitations of the second boss. Specifically, if the second boss has a guaranteed drop, e.g. Gish who drops Little Gish, then the item can only be re-rolled as that guaranteed drop. This happens even if the second boss has not been fought yet.
- Dying with the Ankh, respawning as ??? and killing Mom's Heart or It Lives! will also unlock the Dice.
- It is possible to obtain items obtained through achievements without having to unlock the achievement.
- If the player rerolls the item in the boss room with Curse of the Labyrinth, and one of the bosses is a Harbinger, then the player will always get Cube of Meat for both bosses.