A Pound of Flesh is an unlockable passive item in The Binding of Isaac, added in the Repentance DLC.

Items that require health to purchase now require money instead, and vice-versa.

Consumables in Shops no longer have a cost, but are instead surrounded by spikes that deal a full heart of damage. The pickups inside the spikes cannot be pushed by an explosion.

Buying Shop items for health does not prevent Angel Rooms from appearing.

Immunity from spikes does not prevent damage from the special spikes inside Shops. Invincibility frames or invulnerability from certain items will disallow Isaac from taking the pickups.

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.

Defeat The Beast as Cain.

A Pound of Flesh 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.

A Pound of Flesh

• Makes devil deal items cost money instead of HP
• Makes shop items cost HP instead of money
• Abyss: x1 locust .5x Isaac's damage

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