Challenges

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Alphabirth adds new challenges The Binding of Isaac: Rebirth that each unlock specific items, trinkets, or pickups for Isaac on later runs.

Name Pack Description Items Unlocks
Empty Pack 2.png Only active items spawn, use Void and Abyss to complete the challenge. Abyss + Void Fehu (Rune)
Exploding Head Syndrome! Pack 1.png Isaac is blindfolded and only shoots transcendent ipecac tears in the direction he moves. Pseudobulbar Affect + Ipecac + Continuum Glitched Pickups
Faust Pack 1.png Isaac starts with 12 heart containers; every floor he is automatically teleported to the boss room. He must use his 100% "Deal with the Devil" wisely as he has no access to treasure rooms or shops. Emperor's Crown + Goat Head Emperor's Crown
For The Hoard! Pack 2.png Use your bums and damage upgrades from Hoarder to hoard every pickup throughout the run. Hoarder + Bum Friend + Key Bum Naudiz (Rune)
It Follows Pack 3.png Avoid the Hush laser that slowly follows Isaac. ~ Apparition
Restless Leg Syndrome! Pack 2.png Bombs spawn at Isaac's feet if he stands still for longer than 2 seconds. The damage boost from Hot Coals further encourages continual movement. Hot Coals Sowilo (Rune)
S#!7iest Day Ever! Pack 1.png Isaac is blindfolded and must use Brown Eye poops as his main source of damage. Brown Eye + Brother Bobby + Nun's Habit + 9 Volt Brown Eye
The Collector Pack 2.png Isaac must choose between using pickups traditionally, hoarding them as a way to get extra damage from Hoarder, or absorbing them with Cauldron to gain extra items. Cauldron + Hoarder Gebo (Rune)