Immaculate Conception is an unlockable passive item in The Binding of Isaac, added in the Afterbirth DLC.

Grants a permanent angelic familiar and spawns a Soul Heart for every 15 hearts picked up.

Also works with picking up coins as Keeper or Tainted Keeper.

Possible familiars include:
• Holy Water
• Guardian Angel
• Sworn Protector
• The Relic
• Seraphim

Only one of each familiar can spawn. After all of them have spawned, a Soul Heart will continue to drop after every 15 hearts collected.

Any heart pickups count except for Gold Hearts and Blended Hearts.

This page shows the latest information as of the new Repentance+ (Online Co-op) DLC.
To see information about this item for the previous Repentance version, check this page instead.

Complete Boss Rush as Lilith.

Immaculate Conception can be found in the following item pools:

The following tags are applied to this item:

Below is the Internal Item Description as shown in-game.
Note that some stat changes are not displayed here. Please see the main description for the full effects.

Immaculate Conception

• Picking up 15 hearts spawns an angelic familiar
• After 5 familiars are granted, every 15th heart pickup drops a soul heart
• Abyss: x1 locust .75x Isaac's damage

• Check out the item description on the external Isaac Wiki.