Final answer:
The best item in The Binding of Isaac varies based on playstyle and situation, with Brimstone, Mom's Knife, and Sacred Heart being top contenders due to their substantial impact on gameplay.
Step-by-step explanation:
The question of what's the best item in The Binding of Isaac is highly subjective and can depend on personal playstyle or the specific situation in the game. However, some items are generally accepted by the player community to be extremely powerful. One such item is Brimstone, which replaces Isaac's tears with a powerful blood laser that can deal massive damage to enemies in its path. Another top-tier item is Mom's Knife, which replaces the tears with a knife that can be thrown or used for close combat, dealing significant damage.
It's also worth mentioning Sacred Heart, which greatly increases damage and adds homing effect to tears, making it easier to hit enemies. Ultimately, the best item can vary depending on your run and what synergies you have in play, so it's important to adapt your strategy to the items you encounter. Consideration of how an item complements your current build is key in making the most out of the power-ups available to you in the game.