II - Great Ultimate is an unlockable consumable in Damnation, a mod for The Binding of Isaac.

Depending on how many passive items belongs to the Devil Room or Angel Room Isaac has, triggers different effects:
• If Isaac has no item from Devil Room or Angel Room, he grants Goat Head and Duality for the floor.
If Isaac has both items from Devil Room and Angel Room, remove all of them.
Else, duplicate all these items.

Defeat Hush as Oucal Garlin.

The following special synergies and interactions for II - Great Ultimate have been documented.

* Note that not all possible synergies and interactions are listed here.

• Download Damnation from the Steam Workshop.