Buddy in a Box is an unlockable familiar in The Binding of Isaac, added in the Afterbirth+ DLC.

Spawns a familiar that follows Isaac and has a random appearance, tear effects, fire rate, and damage.

The familiar is randomized each floor using the appearance of co-op babies.

Damage dealt by the familiar scales from ~2-6, while tear delay scales from ~12-30.

Tear effects granted are the same used by Fruit Cake.

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.

Obtain 5 familiars in a single run.

This item contributes towards the Conjoined transformation. Collecting 3 items from this set will make Isaac shoot in 3 directions at the cost of -0.3 damage and -0.3 tears.

Buddy in a Box can be found in the following item pools:

The following tags are applied to this item:

The following special synergies and interactions for Buddy in a Box have been documented.

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

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.

Buddy in a Box

• Grants a following familiar with a randomized appearance, fire rate, damage, and bonus tear effects
• The familiar's traits are randomized at the start of each new floor
• Abyss: x1 locust 1x Isaac's damage

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