Magdalene
Have 7 or more Red Heart Containers at one time
Heart containers, not filled hearts — soul and black hearts do not count. Easiest on a run that finds a couple of Heart-container items early.
All 34 of them — Isaac is there from the start. Open this with the tracker's save on the same device and the ones you still need come to the top.
Unlocks are disabled on pre-set seeds, in Challenges and Daily Challenges, and during Victory Laps. If you are hunting one of these, start an ordinary unseeded run.
The achievement is listed only as "It's complicated", which is why people miss it for hundreds of hours. It is one run, but it has to be the right run.
If you happen to have Spindown Dice and find Mucormycosis, one press turns it straight into the completed Mom's Shovel — skipping both shovel steps.
All seventeen use the same procedure, and the only thing that changes is which character you are playing when you open the closet. One per run.
If the character is already unlocked, or you are playing a tainted character, the closet holds Inner Child instead.
Red Key — the chest in Mom's bedroom contains one the very first time you reach Home, guaranteed. After that it appears rarely, from Curse Rooms, the Key Master, Mom's Chest, Red Chests, Secret and Ultra Secret Rooms.
Cracked Key — this is the one to plan around. Drop any trinket in a Boss Room or a Treasure Room before you pick up Dad's Note, and when the Ascent begins that trinket becomes a Cracked Key in that room. Collect it on the way up. This is exactly what Cracked Key exists for.
To guarantee you have a trinket to sacrifice: clear three consecutive floors without taking damage and Perfection is guaranteed to spawn. Mom's Box generates extra trinkets if you want to seed several rooms at once.
Soul of Cain also opens the closet, but its own unlock is "defeat Hush and Boss Rush as Tainted Cain" — circular, so it is no help for your first tainted characters.
Have 7 or more Red Heart Containers at one time
Heart containers, not filled hearts — soul and black hearts do not count. Easiest on a run that finds a couple of Heart-container items early.
Hold 55 Coins at one time
The coin cap is 99, so this is barely a hurdle. Greed Mode is the fast route: coins pour in and you can bank them without spending.
Defeat Satan
Any character. Take the trapdoor after Mom's Heart or It Lives! instead of the beam of light.
Defeat Mom's Heart 10 times
Cumulative across runs, and It Lives! kills count — you do not have to keep fighting the earlier version.
Don't pick up any hearts for 2 floors in a row
Any heart type breaks it — red, soul, black, eternal. Watch for auto-pickup walking you over one. The trick: play ??? , who cannot pick up red hearts at all, and simply avoid the rest.
Complete 2 floors in a row without taking damage
Self-damage counts, so Curse Rooms, Sacrifice Rooms and Blood Donation Machines all break the streak.
Make 3 Deals with the Devil in one run
Three Devil items in one run, which means keeping your Devil Room chance alive across several floors — do not take damage on the boss floors. A Black Market counts.
Have 4 or more Soul Hearts at one time
Black hearts count as soul hearts for this one.
Complete Chapter 4
Just beat Mom's Heart or It Lives! once, clearing the Womb.
Die in a Sacrifice Room while holding Missing Poster
Die in a Sacrifice Room while holding Missing Poster. Missing Poster itself needs unlocking first — defeat The Lamb as Isaac.
Finding the trinket is the real work: check shops for Mom's Box, and Glyph of Balance turns champion drops and room-clear rewards into trinkets while you hold none, which massively improves the odds.
Two traps. Sacrificing 6 times in a row gives a 33% chance of an Angel Room teleport and 12+ gives a 50% Dark Room teleport — so keep your total health at 11 hearts or fewer before the killing blow, and if you teleport out at the instant of death it does not register. You do not have to die to the spikes; any damage in the room works.
Defeat Ultra Greed as Azazel
Greed Mode, not Greedier.
Donate 1000 Coins to the Greed Donation Machine
Cumulative across runs. The machine jams from time to time; jam chance is per character, so switching characters resets it.
Defeat Mega Satan
Needs Key Piece 1 and Key Piece 2 from the angels, then the golden door in the starting room of The Chest or the Dark Room.
It's complicated
Defeat Mom's Heart or It Lives! on hard mode as Lazarus, without dying at all
The in-game text says "beat Hard mode as Lazarus without losing a life" — and Lazarus's own revival counts as losing one. Dying and continuing as Lazarus Risen fails it.
Defeat Mother
Any character. Mother is the Corpse II boss at the end of the alternate path — Downpour, Mines, Mausoleum, Corpse.
Use Red Key (etc.) to open the hidden closet in Home as Isaac
Play as Isaac and open the closet in Home. See the procedure above.
Use Red Key (etc.) to open the hidden closet in Home as Magdalene
Play as Magdalene and open the closet in Home. See the procedure above.
Use Red Key (etc.) to open the hidden closet in Home as Cain
Play as Cain and open the closet in Home. See the procedure above.
Use Red Key (etc.) to open the hidden closet in Home as Judas
Play as Judas and open the closet in Home. See the procedure above.
Use Red Key (etc.) to open the hidden closet in Home as ???
Play as ??? and open the closet in Home. See the procedure above.
Use Red Key (etc.) to open the hidden closet in Home as Eve
Play as Eve and open the closet in Home. See the procedure above.
Use Red Key (etc.) to open the hidden closet in Home as Samson
Play as Samson and open the closet in Home. See the procedure above.
Use Red Key (etc.) to open the hidden closet in Home as Azazel
Play as Azazel and open the closet in Home. See the procedure above.
Use Red Key (etc.) to open the hidden closet in Home as Lazarus
Play as Lazarus and open the closet in Home. See the procedure above.
Use Red Key (etc.) to open the hidden closet in Home as Eden
Play as Eden and open the closet in Home. See the procedure above.
Use Red Key (etc.) to open the hidden closet in Home as The Lost
Play as The Lost and open the closet in Home. See the procedure above.
Use Red Key (etc.) to open the hidden closet in Home as Lilith
Play as Lilith and open the closet in Home. See the procedure above.
Use Red Key (etc.) to open the hidden closet in Home as Keeper
Play as Keeper and open the closet in Home. See the procedure above.
Use Red Key (etc.) to open the hidden closet in Home as Apollyon
Play as Apollyon and open the closet in Home. See the procedure above.
Use Red Key (etc.) to open the hidden closet in Home as The Forgotten
Play as The Forgotten and open the closet in Home. See the procedure above.
Use Red Key (etc.) to open the hidden closet in Home as Bethany
Play as Bethany and open the closet in Home. See the procedure above.
Use Red Key (etc.) to open the hidden closet in Home as Jacob and Esau
Play as Jacob and Esau and open the closet in Home. See the procedure above.