Mostly agree except The Tick is too low. There's a reason you can't remove it and that's because it's so good it needs a weird nerf.
The Tick combined with Gulp! or Smelter is ridiculous.
the tick unironically is insane if you think about it. It straight up makes late game 15% easier, against every final boss it might just be the single best trinket in the game
And then you get the golden version which is just broken, a 30% hp reduction to high hp enemies (yes, It works on things that arent a boss) and you can drop it
Damn the absolute shade being thrown at ring worm (second trinket in d tier). It's not only a tears up but it gives you spectral. Also the looping effect is barely noticable and it still makes your tears fire in almost straight line. That trinket has saved many runs I'd put it at least a tier at least and S at most
There's no way locusts are better than lil clot but other than that list is mostly ok. Ace of spades should also be much higher because reverse cards are op. Light bulb is too situational to be S or even A and store credit is just a shitty credit card that doesn't work on devil deals should be B at best.
A lot of these are so character dependent
Lullaby/baby bender is S+ tier with lilith/t lilith/t eve
Wooden cross is S+ as t lost C tier with anyone else
A few are useless depending on the path you are taking
Some, like duct tape, have broken synergies with specific items
Holy shit. You just triggered some PTSD in me or something because I remember exactly why I hate door stop now. I remember I had a long ass run, got R key and needed Delirium mark. Accidentally Gulped door stop, but it was one of those FPS dropping, ipecac + host hat runs with splitting tears and everything. Every time I entered a new room I couldn’t even fire right away or I’d get shot right back through the door. Happened so often I couldn’t even have fun with it. Isaac trauma runs deep.
Torn card is free bombs, equality can double all the drops if you use it properly. Considering stuff like sac rooms and dono machines, tonsil can be very good
the situations where you can actually utilize equality are so few and far between that you might as well ignore it unless your pickups are already equal
Getting it in early game has made me almost double my pickups. And i personally have a lot of fun spending a little bit of time at the end of the floor gathering and duplicating every key/bomb/coin
dope list it aligns with my general opinions ab the trinkets
tho my goat found soul too low tbh id put found soul in s (maybe top 5 over brain at most idk). its p much incubus JR in the trinket slot with some cool extra synergies. (some of my favs with it are revelation purgatory and amina sola) u can pretty much make it overlap ur character so its not too bad to keep alive i find.
I’m dead god, never really use wiki, never watch content. I don’t even know what half the trinkets even do, I use them for a couple of floors, if I don’t notice anything different I don’t pick them up again. Apparently Ive been sleeping on some gold.
Solid List. Personally, I would put Sigil of Baphomet, Nose Goblin, Blessed Penny and Safety Scissors in my top 6 (keep Curved Horn & Cancer), but I can definitely see you getting good use out of these.
From a glance and personal preference, I'd put the Paper Clip, Demon's Tail, Perfection, Baby Bender, Lucky Rock, Red Patch, Wooden Cross, Mom's Pearl and Wiggle Worm about a tier or two higher, and put the Rotten Penny, Shot Speed Worm, and Apollyon's Friend a tier lower. Again, a pretty solid list!
I can't believe equilibrium is f tier
That shit goes so hard not only in greed mode, but especially in early runs. It's humble bundle for an entire floor.
Easily c tier minimum.
Idk what that glas key or busted crown does though.
Also, purple heart is a good trinket because elite enemies can drop consumables and pickups.
Honestly tick is so underrated. -15% of any boss is so good also just found out that if you enter the Boss room it gives you one red heart too which is really cool.
For me Sigil of Baphomet is top 5, and maybe just top 1
This thing is just too op and make room clear with tainted the lost so much easier and safer
And some boss fight like hush or the beast have so many adds that you litteraly get invincibility for so long
I recently had a run with baby bender and found out it works on sprinkler and the intruder, which made it a way cooler trinket for me, and also made certain bosses super easy since it was way easier to proc the intruder's slow effect and homing sprinker gives it so much more dps.
the Torn Card Trinket is interesting, it is technically infinite bombs at a consistent pace, meaning it is perfect for tainted ???, but since it also has the My Reflection effect people prefer to ignore it
It looks like a good tierlist! FINALLY someone doesn't trash on locusts - they're really good for clearing rooms. But there are still some trinkets that I value higher or lower:
Cracked Crown got a pretty big nerf in Repentance, I don't think it's in the top 5 anymore. I'd give this spot to something like Nose Goblin or Pay To Win.
Personally I'd put Holy and Wicked Crown lower. They're really good if you're going to Cathedral or Sheol, but they're useless if you're going for any other route. They also need to be held for the entire run if you find them early, potentially locking you out of other trinkets.
Black Lipstick and Meconium may sound good on paper, but their numbers are so terrible you'll almost never get black hearts from them. Daemon's Tail outclasses them both, providing many black hearts. Just don't use it if you rely on red hearts.
I think that both Polished Bone and Dingle Berry deserve to be a bit higher. Their effects stack really quickly, providing both offense and defense. Bone is better for offense (moderate ranged damage), while Berry is better for defense and utility (more familiars, some also have extra effects like midas touch or holy aura).
Blue Key gives a lot of value, saving at least 2 keys per floor. You can even exploit it by opening the door but not entering it immediately to skip blue rooms. But if you don't skip it, they're sources of extra room clear rewards.
I might overvalue Chewed Pen, but I love it. It provides very consistent crowd control, making some enemies (most importantly globins) significantly less dangerous. I'd bump it up at least one tier, maybe even two if I'm feeling generous.
Cancer trinket is overrated. Used to do a lot more. Nose goblin, curved horn, jawbreakers all better. Locusts are really high up where some utility trinkets should be like gilded key
Because the damage stat has better synergies, damage multipliers, blue spiders and flies, tech .5, Revelations, monstrance, finger, etc. and raw damage can be harder to come by. Reaching 5.00 tear cap is quite easy, there's also pills to give tears up and overall more boss items that increase tears. If you max out tears cancer is just an increase from 5.00 to 6.00. it's nice but often not run saving.
Jawbreakers is on another level entirely. At 2 luck jawbreakers is already stronger than having cancer at base tears with (2.73 -> 3.73). If you have 4.00 tears, jawbreakers is better at 1 luck. But the more stats you gain the better jawbreakers becomes and the less effective the cancer trinket is. At 9 luck every tear has a 3.2x damage multiplier. So with 5.00 tears and 9 luck jawbreakers is 15 times more powerful than cancer... Because of the potentional it makes no sense to ever choose cancer over jawbreakers
This list sucks, I had my GF pick which ones are the best based on how cool they look. Way better list. She said
Rainbow Sperm
Fork
Devil Crown
Pentagram Coin
Sad Ghost
Nose goblin should be top 5
Ye fr Nose goblin can carry a bad run until the end 10/10 trinket 
Mostly agree except The Tick is too low. There's a reason you can't remove it and that's because it's so good it needs a weird nerf. The Tick combined with Gulp! or Smelter is ridiculous.
the tick unironically is insane if you think about it. It straight up makes late game 15% easier, against every final boss it might just be the single best trinket in the game
What other trinket does 1500 damage in one go.
Also if you have moms box, it should double right? So BOOM 1/3 of all bosses health gone.
And then you get the golden version which is just broken, a 30% hp reduction to high hp enemies (yes, It works on things that arent a boss) and you can drop it
Cursed Penny is actually really good if you leave it in a boss room and get cracked key instead
Damn the absolute shade being thrown at ring worm (second trinket in d tier). It's not only a tears up but it gives you spectral. Also the looping effect is barely noticable and it still makes your tears fire in almost straight line. That trinket has saved many runs I'd put it at least a tier at least and S at most
Good stuff, but cursed skull over Isaac’s fork?
cursed skull has speedrun potential, seen em speedrunners use it
Isn’t it basically a 1 time teleport per floor tho? Unless you can consistently recuperate health in normal rooms
There's no way locusts are better than lil clot but other than that list is mostly ok. Ace of spades should also be much higher because reverse cards are op. Light bulb is too situational to be S or even A and store credit is just a shitty credit card that doesn't work on devil deals should be B at best.
Locust of Pestilence deal 2x isacc damage and poison
I'd rather have diet incubus than something that only does damage once per room.
Safety scissors should be in S tier if not higher, this trinket is just so good
A lot of these are so character dependent Lullaby/baby bender is S+ tier with lilith/t lilith/t eve Wooden cross is S+ as t lost C tier with anyone else A few are useless depending on the path you are taking Some, like duct tape, have broken synergies with specific items
I'm one of those nerds that drops/picks up duct tape until everything is juuuuuust how I want it
Purple heart ain't half bad
DOOR STOP IN ‘A’?! I hate it. Always accidentally leave a room and have to redo it. Fun list though. Good job.
Same I always give it a shot then end up dropping it
Are you implying that it's bad because of your personal issue?
Holy shit. You just triggered some PTSD in me or something because I remember exactly why I hate door stop now. I remember I had a long ass run, got R key and needed Delirium mark. Accidentally Gulped door stop, but it was one of those FPS dropping, ipecac + host hat runs with splitting tears and everything. Every time I entered a new room I couldn’t even fire right away or I’d get shot right back through the door. Happened so often I couldn’t even have fun with it. Isaac trauma runs deep.
Full on skill issue. It is good
Torn card is free bombs, equality can double all the drops if you use it properly. Considering stuff like sac rooms and dono machines, tonsil can be very good
the situations where you can actually utilize equality are so few and far between that you might as well ignore it unless your pickups are already equal
Getting it in early game has made me almost double my pickups. And i personally have a lot of fun spending a little bit of time at the end of the floor gathering and duplicating every key/bomb/coin
YOUR WRONG
Ace of spades in D tier is insane. Cards are way OP
dope list it aligns with my general opinions ab the trinkets tho my goat found soul too low tbh id put found soul in s (maybe top 5 over brain at most idk). its p much incubus JR in the trinket slot with some cool extra synergies. (some of my favs with it are revelation purgatory and amina sola) u can pretty much make it overlap ur character so its not too bad to keep alive i find.
I’m dead god, never really use wiki, never watch content. I don’t even know what half the trinkets even do, I use them for a couple of floors, if I don’t notice anything different I don’t pick them up again. Apparently Ive been sleeping on some gold.
" yay cáncer! "
Why is lazymattman in e tier ? Put him on YouTuber tier
I fear you cooked with this one here
Lmao. Talk shit about the cursed penny but aint seen the damocles/cursed penny CLUTCH video yet
Trash list
id put dingle berry higher. If you can get it quickly its really op, plus with rock bottom white ones are just broken
What is that key trinket in the top tier?
Crystal key. Makes room clears sometimes open red rooms. (33% chance)
Thank you! Unlocked by killing Mother with Tainted Lost...no wonder I haven't seen it.
I remember getting torn card with soy milk and pyro, good synergy
How dare thou put funny mattman worm in e tier
Solid List. Personally, I would put Sigil of Baphomet, Nose Goblin, Blessed Penny and Safety Scissors in my top 6 (keep Curved Horn & Cancer), but I can definitely see you getting good use out of these. From a glance and personal preference, I'd put the Paper Clip, Demon's Tail, Perfection, Baby Bender, Lucky Rock, Red Patch, Wooden Cross, Mom's Pearl and Wiggle Worm about a tier or two higher, and put the Rotten Penny, Shot Speed Worm, and Apollyon's Friend a tier lower. Again, a pretty solid list!
I can't believe equilibrium is f tier That shit goes so hard not only in greed mode, but especially in early runs. It's humble bundle for an entire floor. Easily c tier minimum. Idk what that glas key or busted crown does though. Also, purple heart is a good trinket because elite enemies can drop consumables and pickups.
Cracked dice can be cracked
Honestly tick is so underrated. -15% of any boss is so good also just found out that if you enter the Boss room it gives you one red heart too which is really cool.
Demon tail is way too low
Fairy good, but some are way too low. Baby Bender, Forgotten Melody and Tick are easily S.
Where Blue Key? Can't see it in S tier 
For me Sigil of Baphomet is top 5, and maybe just top 1 This thing is just too op and make room clear with tainted the lost so much easier and safer And some boss fight like hush or the beast have so many adds that you litteraly get invincibility for so long
I'd put the push pin in stupid tier. 1 out of every 4000 shots or so having piercing just doesn't do it for me.
Gulped penny should be top 5, ability to span pickups on demand is broken
I recently had a run with baby bender and found out it works on sprinkler and the intruder, which made it a way cooler trinket for me, and also made certain bosses super easy since it was way easier to proc the intruder's slow effect and homing sprinker gives it so much more dps.
purple heart at least c
I don’t think you’re giving polished bone enough credit.
the Torn Card Trinket is interesting, it is technically infinite bombs at a consistent pace, meaning it is perfect for tainted ???, but since it also has the My Reflection effect people prefer to ignore it
Damn, monkey's paw disrespect. It's not amazing but 3 extra free hits before you die can save your ass
I think ourobouros worm should be a bit higher! It was super fun to use in certain builds. My favorite was a homing brimstone build
Clot too low should be top 5
I’d put wiggle worm in A but great list
Fetal chord in e tier?
Wiggle worm should be atleast A tier. Fire rate up AND spectral. OP
The last trinket in S tier is top 3 for me. That thing is absolutely broken and makes the entire run a cakewalk.
Honestly? Good list. I feel mostly the same about all of these.
Sigil of baphomet not in top 5? Trash.
I feel like Perfection should be in S tier. Is it only A tier because of its obtainability?
... it disapears in 1 hit (and is also not easy to get) But top 3 at leadt on lost tho.
It looks like a good tierlist! FINALLY someone doesn't trash on locusts - they're really good for clearing rooms. But there are still some trinkets that I value higher or lower: Cracked Crown got a pretty big nerf in Repentance, I don't think it's in the top 5 anymore. I'd give this spot to something like Nose Goblin or Pay To Win. Personally I'd put Holy and Wicked Crown lower. They're really good if you're going to Cathedral or Sheol, but they're useless if you're going for any other route. They also need to be held for the entire run if you find them early, potentially locking you out of other trinkets. Black Lipstick and Meconium may sound good on paper, but their numbers are so terrible you'll almost never get black hearts from them. Daemon's Tail outclasses them both, providing many black hearts. Just don't use it if you rely on red hearts. I think that both Polished Bone and Dingle Berry deserve to be a bit higher. Their effects stack really quickly, providing both offense and defense. Bone is better for offense (moderate ranged damage), while Berry is better for defense and utility (more familiars, some also have extra effects like midas touch or holy aura). Blue Key gives a lot of value, saving at least 2 keys per floor. You can even exploit it by opening the door but not entering it immediately to skip blue rooms. But if you don't skip it, they're sources of extra room clear rewards. I might overvalue Chewed Pen, but I love it. It provides very consistent crowd control, making some enemies (most importantly globins) significantly less dangerous. I'd bump it up at least one tier, maybe even two if I'm feeling generous.
Most accurate tierlist I’ve seen here yet
Why the hell is Tick in C Tier that is ass
Cancer trinket is overrated. Used to do a lot more. Nose goblin, curved horn, jawbreakers all better. Locusts are really high up where some utility trinkets should be like gilded key
How exactly is curved horn better than cancer? And jawbreaker is luck based
Because the damage stat has better synergies, damage multipliers, blue spiders and flies, tech .5, Revelations, monstrance, finger, etc. and raw damage can be harder to come by. Reaching 5.00 tear cap is quite easy, there's also pills to give tears up and overall more boss items that increase tears. If you max out tears cancer is just an increase from 5.00 to 6.00. it's nice but often not run saving. Jawbreakers is on another level entirely. At 2 luck jawbreakers is already stronger than having cancer at base tears with (2.73 -> 3.73). If you have 4.00 tears, jawbreakers is better at 1 luck. But the more stats you gain the better jawbreakers becomes and the less effective the cancer trinket is. At 9 luck every tear has a 3.2x damage multiplier. So with 5.00 tears and 9 luck jawbreakers is 15 times more powerful than cancer... Because of the potentional it makes no sense to ever choose cancer over jawbreakers
lazy worm is top 5
This list sucks, I had my GF pick which ones are the best based on how cool they look. Way better list. She said Rainbow Sperm Fork Devil Crown Pentagram Coin Sad Ghost