TBOI Quality 4 Items Alignment Chart

Quality 4 items in The Binding of Isaac as of Repentance+

Create a TBOI Quality 4 Items alignment chart. Check out our other Video Games tier list templates and the most recent user submitted Video Games tier lists.

Template last modified: 07/05/2026

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Credit to https://bindingofisaacrebirth.wiki.gg/ for the images.