Binding of Isaac: Afterbirth Plus Review

A Truly Endless Game?

Back in 2011, prominent indie game designers Ed McMillen and Florian Himsl came together for a week long game jam to make a game like they used to. With the goals of making a Legend of Zelda (NES) inspired rogue-like that also touched on McMillen’s conflicting ideas about religion, the two created the game in Flash and it quickly became a phenomenon. Now, Nicalis brings us a new expansion, Afterbirth Plus.

The game touched on something video games had openly avoided and the ugly side of it at that. Based loosely around the biblical story of the Binding of Isaac, the game stars Isaac who flees a mother who believes she was asked by God to purify her son by stripping him of all his possessions and even kill the boy. Isaac escapes through a trap door, leading to the dark, twisted basement where he fights his grotesque mother, demons, and other horrors. In 2014, Nicalis revised the game as Binding of Isaac: Rebirth, expanding it with a new engine and a sprite-based art style, while also adding an incredible amount of items, characters, and monsters. Further supporting the game, Nicalis released Afterbirth, an expansion that adds even more to the base game. Recently, Nicalis released Afterbirth Plus, which adds that much more to the game, while also adding mod support and tools.

Afterbirth Plus Monstro Boss

Take on massive bosses like Monstro. He’s small comparatively.

For this review, we’ll be exploring the game anew. I last played Rebirth in my review for Giga Geek Magazine when it was made free for PlayStation Plus members, but I didn’t get to dive as deep into it, so I’ll be covering some broad strokes initially in this review. Also, I want to explain some of the major differences added in Afterbirth Plus, as it can get a bit confusing after a while. Lastly, I’ll be exploring the new mod support, discussing its implications as well as touching a bit on some solid mods. Later on, I’ll be doing a list of some of the best Binding of Isaac: Afterbirth Plus mods out there, so please look forward to that. With all of this setup out of the way, let’s dive into the basement once again to see what Binding of Isaac: Afterbirth Plus has to offer.

Binding of Isaac takes the visual dungeon layout of classic 2D Zelda games (NES, Link to the Past, Link’s Awakening) and adds in bullet hell shooting. Floors are randomly generated, as are the items that augment or hinder the player’s character. For example, the Fish Head item spawns a blue fly every time Isaac takes damage, while Lil’ Brimstone gives the player a demonic buddy that spouts massive lasers from its mouth. These items can also stack, which can create some crazy effects, especially with Isaac’s main form of attack, his tears. Where Isaac truly shines is how no two runs feel the same. With the sheer amount of items, monsters, and combinations available, each character will end up different at the end, a conglomerate monster of its former, more innocent self. This obvious metaphor also shows just how the game’s grander ideas are presented. To battle these grotesque monsters, the player must in turn become a monster.

Afterbirth Plus Azazel Boss

Becoming more monstrous is a necessary evil.

The creatures Isaac faces are some of the most disturbingly designed monsters in all of gaming. Enemies moan in permanent turmoil and attack with all manners of foul projectile, often times including fecal matter. Bosses are especially sickening, with some of them being piles of throbbing offal, but still somehow being cute with the game’s unique art style. These bosses will test the players tenacity as many of their attacks have Isaac dancing around waves of projectiles and screen-filling blasts. At first, the goal is just to get out the basement by facing Mom in the darkest reaches, blasting her eyes, feet, and flabby flesh. Defeating her is just the beginning, as more deadly enemies flood the basement after her demise.

What’s crazy about playing the Binding of Isaac is the sheer amount of secrets sprinkled in its level design. Sacrifice rooms, seemingly red herrings that are just rooms with a single tile of spikes in them, are actually used to gain blessings. These blessings can lead to angel doors after bosses, which have a set of items based on these holy themes. Not only that, but many walls are able to be blasted open using bombs and a bit of luck. Add in the long list of playable characters, each with their own special set of starting stats and items, plus the multitude of endings and areas to explore, and the stage is set for a truly endless game.

I’ve sunk in almost twenty hours and I feel like I’ve only scratched the surface, barely uncovering the rich layers the game offers to those who continue to dive into the darkness. Sometimes, I walk away from a session disturbed, either by the imagery or a visually striking ending. Usually, the rest of my day is filled with speculation on the deeper meaning. I mentally wrestle with conflicting ideologies as I have seen both the kindness religion can bring to the soul and the darkness that borders demonic possession. I’ve seen groups of people cast down those who aren’t like them, while also preaching for peace. I’ve seen kind old ladies yell in languages I couldn’t fathom, a cultural symbol of their faith that showed their true acceptance of the Savior. At one point, I relished in these moments, taking in the swell of energy. After a few years though, I began to develop a fear of these people and their ways of showing faith. That seeded fear never leaves and will continue to haunt me for the rest of my days. That’s just the type of thing McMillen and Himsl were getting at in their original prototype; religion is a powerful force, so much so that it is terrifying.

Afterbirth Plus Character Select

Each of these character kind of have a story, often built on characters from biblical works.

Everything in the Binding of Isaac is created with this major theme in mind. The soundtrack is often daunting, filled with slightly off melodies and chorus singers, but then shifts to driving guitar as Isaac reaches the last mountains to overcome in a show of vulgar defiance. Those tracks coupled with the sound design makes it easy to get lost in the maze that is the basement. There are few games that really nail their tone and theme like the Binding of Isaac does.

Completing the game is a monumental task, as there is a checklist of things that need to be done with each character, let alone unlocking these children to begin with. Completionists beware, the Binding of Isaac will consume you. While browsing the many different streams and videos online, I did see a trend that those who were creating the best content about the game, had finished the game to completion. All the items were gotten at least once, all the secrets uncovered, and all the endings seen. It blows my mind that this is even possible. With the amount of randomness built into the game, I don’t think I could ever finish it. I’ve always considered the Binding of Isaac endless.

While many players have completed the game, with the addition of modding tools packed into Afterbirth Plus, there is an added layer of longevity. Modders are able to change just about everything in the game, with a vast set of simple looking tools. We’ve been given the key to the city and already creators have developed some amazing projects. I’ve seen simple mods, like adding a single new character or changing the UI, but some are far more ambitious. Complete conversion mods seek to make whole new games, usually revolving around a central theme. One of the best according to Isaac streamers is Antibirth, a mod that feels like an official expansion with everything that would entail in such a project.

Afterbirth Plus MOD Antibirth

Antibirth feels like a massive expansion worthy of an official release. The Platinum God guide even includes it in their database.

To me one of the most interesting mods was the Binding of Undertale, which is as awesome as it sounds. The world of monsters and moral turmoil fits perfectly into the Isaac mold, so much so that it seems like destiny. Players can become their favorite characters from Undertale, like Sans, Papyrus, or Frisk and battle against the basement in a continuously expanding adventure. I cannot wait to see what this mod looks like in a year or so, as they’re already adding epic bosses and cool spins to the items.

Afterbirth Plus Binding of Undertale Mod

Mods like the Binding of Undertale add a ton of longevity to the game.

This is why I have to consider the Binding of Isaac: Afterbirth Plus a perfect game, the first that I have ever rated this high, even beating out Final Fantasy XV and Shantae: Half Genie Hero. While both of those games were amazing, Afterbirth Plus is built to literally be endless. As big as the fan base is, we could be playing Binding of Isaac mods for the next thirty years or more with plenty of interesting developments along the way. Truly McMillen and Himsl caught lightning in a bottle the day they put their heads together to come up with the idea.

I think as long as I can physically play games, I’ll be playing the Binding of Isaac, a timeless classic with layers of meaning and importance. Congratulations McMillen, Himsl and the entire Nicalis team, you’ve made a masterpiece.

Afterbirth Plus Nicalis Team

Thank you.

For a stellar guide on items and more, check out Platinum God, a cheat sheet that’s incredibly extensive.


  • Deep themes complemented through both visual and audio design
  • Addictive gameplay inspired by NES Zelda
  • Randomized runs makes no two sessions feel the same


  • Can't quit my job to keep playing


Gameplay - 10
Controls - 10
Music/Sound - 10
Graphics - 10
Replay Value - 10

Most people bleed red. Alex bleeds pixels. Hailing from the deep mountains of WV, land of beautiful landscapes and internet scarceness, Alex can be found writing about games in every sense. Retro games are his life, spending more time with his GBA than his PS4. Drop by one of the social doodads for deep discussions about gaming!

  • Dragon

    It looks like this review is your opinion about the game as a whole, rather than just the last DLC ‘afterbirth plus’. I fully agree that BOI Rebirth deserves a 10. But afterbirth plus was kinda disappointing to me and many others.

    Major downsides about the AB+ DLC:
    – same price as Afterbirth…. half the content. (highering the price because it contains mod-tools is bs, since most players won’t use them)
    – Multiple rooms got added with practically unavoidable damage because they placed too many enemies. (these rooms mostly occur in the caves)
    – Most of the new items are almost the same as already existing items.
    – The new chapter didn’t add anything new apart from the new boss.
    – Up until today, the new boss is very glitchy. It has multiple glitches that cause unavoidable damage.

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