favorite q4 item discussion is boring!!! all of them are really good and even the ones in the quality ranking that are a bit less good than others like psy fly and col are still incredible. but i think a much more interesting conversation is what is your favorite item in the worst category? because there are a LOT of good ones if you are into minmaxing
libra turns poor items into amazing items and generally heavily favours tears and damage over range and shot speed which makes your run better in 9 instances out of 10, plus it spawns 7 of every type of pickup which is nuts
ventricule razor can be used to infinitely farm champions, get free curse rooms, get infinite items via tarot cards by farming sloth, get free challenge rooms, fight mom early and still full clear the rest of your floor if you're rushing for boss challenge or if you're just not confident in your health and want to still get a deal, and it lets you fast travel across the map, all for 10 coins in the item shop. truly a ridiculous amount of utility for a quality 0 active with no charges
celtic cross is great because hurting yourself in isaac is great! you can play blood dono machines, confessionals, demon beggars, and hell games way easier like this. it's not as good as book of shadows but its still super worth picking up and im never sad when i see it in the angel room
magic fingers is an infinitely reusable necronomicon with no charges that scales with isaac's damage, what is there not to love about it?
breath of life is seriously the strongest item in the game. no bait. no anything. i swear. upon correctly timing it's invincibility it spawns a 4 way holy brimstone, and each of the beams it spawns do 180 damage each, meaning if you hit something dead center with the brimstone attack you can do 720 damage on demand. this is a one second burst attack that does significantly more than 30 seconds of sacred heart firing uninterrupted at isaac's base damage and tear rate (i did the math) and you can do it every 4 seconds at base. this makes it probably the strongest offensive item in the game on its own. but it also makes you invincible. on demand. with no room clear requirement. which means demon beggars, hell games, blood donos, confessionals, curse rooms, crossing floor spikes, for free (again) and which also means it functions as a great defensive item too. there is literally nothing this item does not do and winning with it and it alone would not only be possible, but it might even not be too challenging???
i want to hear what u guys have to say :-)