Astrology might be garbage, nobody cares if you are a Leo and some app said that you would meet a Gemini today and fall in love. But the Zodiac items are a very powerful addition to any run, with varying effects. Today I will try to make a subjective ranking of these items

Before we start, this list only covers the Afterbirth items. The mod additions such as Sol, Luna, etc are fun, but not a part of this list. Also, Zodiac and Crystal Ball are not in this list, the former because its a random zodiac effect per floor and the latter because it doesn’t fit the billing.

12. Aries

Coming in at last place, Aries is a flat +0.25 to speed and gives Isaac the ability to damage opponents by running into them. Its certainly not terrible, with shielding or invincibility you get some use out of the added damage without orbitals. But even then you need to back up and slam into them repeatedly for a measly 18 dmg per hit. Stick to Cube of Meat

11. Aquarius

Causes Isaac to leave a trail of damaging watery creep, like Depression. Its really meh, but it has utility fighting enemies that chase Isaac, and its better than the red creep left by Headless Baby and Anaemic because it doesn’t cause confusion with enemies that do the same

10. Leo

Allows Isaac to crush rocks by walking over them. Useful early game, when bombs are at a premium and you see tons of pots and tinted rocks for coins and soul hearts. But later in the game it can be a major hindrance. Mushrooms, bomb rocks and Polyps become instant hazards. And it prevents Isaac from the age-old method of safety, which is hiding over rocks. This item really blows for the Lost

9. Gemini

A suture grows out of Isaac, similar to the boss by the same name as the item, which damages enemy within its range. Underwhelming, but with no major downsides (explody enemies notwithstanding). It is fun to see the suture baby go all red attacking enemies. Can also be used as a sacrifice for Sac Altar

8. Taurus

Severely underrated item. Gives Isaac a decent speed down on pickup, but every time he enters an unfriendly room, his speed increases gradually. When it hits 2.0, it procs the My Little Unicorn effect temporarily. This item seems kinda useless when your speed is very low, but through items and pills it can rise back up fairly quickly. And when it does, you get a free invulnerability in rooms within no time. Can clear rooms quickly with a good orbital

7. Pisces

Grants Isaac a -1 Tear Delay down and increases the size and knock-back of his tears. Not sure exactly where fishes factor into this but its a nifty item, capable of breaking the tear cap and the increased knock back is sometimes useful too. I will say that the tears being larger gives a feeling of higher damage output that can be deceptive, but thats not a problem with the item, its with our own brain

6. Scorpio

Makes Isaac fire tears that inflict the poison effect, which deals damage over time while the effect is in place. Poison is a very nice tear effect, which works even with knife, brimstone, etc. It is brilliant in conjunction with Serpent’s Kiss, generating Black Hearts for days

5. Capricorn

One of the best “all stats up” in the game. Works similar to SMB, Halo in that it grants a red heart container and increases all stats except shot speed. Difference is it grants a -1 Tear Delay Down which allows it to break the tear cap. Gives Isaac a scruffy goatee to boot

4. Sagittarius

Grants Isaac a +0.2 speed increase and piercing tears. Piercing is a superb tear effect that helps greatly with crowd control and damage output, and is not that common to find in other items (w/o modifying tears into say knife laser or brimstone). Watch out for Dr Fetus or Ipecac though

3. Virgo

Gives the PhD effect in that it turns all bad pills to their good counterpart (tears down to tears up, I’m excited to I’m drowsy, etc), except it doesn’t reveal the pill name from the start. It also gives a chance to proc a shield for 10 seconds upon taking damage. Seems underwhelming at first but both its effects are excellent, be it getting a clutch Balls of Steel pill when you need health, or getting the damage shield in a boss fight. The pretty bow also goes well with other outfits

2. Cancer

YES, I got Cancer!

-only BoI players, probably

Cancer, be it the trinket or item, are both amazing. Gives 2 soul hearts on pickup, as well as a conditional Wafer effect, wherein after the first hit in a room, all damage taken is restricted to half a heart. This is an incredible boost to survivability, as it essentially doubles your remaining health after the Mom fight. To know if the effect is active, check to see if there is a light blue glow around Isaac.

1. Libra

The infamous. The sullied. The “err should I take it?” The item that makes Soy Milk go from F to S++ tier

What does it do? For starters, it gives 7 coins, 7 bombs and 7 keys. Honestly even if it did just that it would be pretty good. But it also balances out all your stats. Its tough to explain numerically, but essentially every stat is combined and then distributed equally in a ratio-ed manner. So for example, if you have a very high speed stat but are lagging elsewhere, upon picking up Libra your speed stat will decrease sharply but all other stats will get a buff

I can wax lyrical about Libra for days, and probably will in a separate post. It does have noticeable downsides though. Certain items become overall stat downs, such as Eve’s Mascara or Mini Mush. And it also prevents large stat ups from being as pronounced, for example Cricket’s Head wont increase damage as much as without Libra, and so it prevents you from getting wildly overpowered late game. But ultimately it makes for safer runs, providing more utility to items which give stats like speed and especially range. It also allows for madness like breaking the tear cap even with modifiers like Mutant Spider, Polyphemus, etc

So thats the list, which we also TL;DR here. Let me know what you think in the comments!

Libra Cancer Virgo Sagittarius Capricorn Scorpio Pisces Taurus Gemini Leo Aquarius Aries