Items in Risk Of Rain Returns are intrinsic to the game itself. Essential to both the lore and in-game progression. Here I will rank 15 of the top most useful items, excluding equipment, based on: rarity, versatility and current meta with the available survivors, and finally, how easy they are to unlock.
Now, from good to best, here are the most desirable items you can collect from the wreckage of the UES Contact Light: 

“On my way to crash this ship” 

15. Mocha  

Rarity: Common 

Increases movement speed by 7.5% (+7.5% per stack) and attack speed by 6% (+6% per stack). 

To unlock, level up to level 20.  

As a common item, Mocha is easily found throughout every stage and possibly found in any chest. Mocha is great for every character except Artificer, as their main attack is a set stack of 5 shots, and Sniper, as their DPS cannot be increased because of their reload mechanic. However, the Mocha can still provide a small movement speed increase to everyone, and an attack speed increase to the vast majority of survivors. Considering it only grants a buff of 6% attack speed and a flat 1.5 KM/H movement speed, unlike what it says in the item description, which pales in comparison to that of the Soldier’s Syringe and Paul’s Goat Hoof. The Mocha gets placed last on this list, due to it being easily replaceable by the aforementioned items. 

“Rarer than Rare” 

14. Insecticide 

Rarity: Uncommon 

10% (+5% per stack) chance on hit to spray an enemy dealing 10% damage per second. Spray stacks up to 10 times. Killing enemies heals for 10 (+5 per stack) health per stack of spray. 

To unlock, complete the providence trial “Get Off My Lawn!” 

When you inflict damage after collecting the Insecticide item there is a chance to inflict a poison debuff that hurts the target over some time, if the enemy dies in this time, they drop a healing orb, similar to the Monster Tooth. While both dealing damage and returning health this item is a great addition to most melee classes and high DPS characters, being most effective for Acrid and Huntress. Although, the damage wrought and health received are sub-par, that paired with only a 10% chance to PROC is why the Insecticide is so low on the list. 

“The hardest trials go to the strongest warriors” 

13. Soldier’s Syringe 

Rarity: Common 

Increases attack speed by 12% (+12% per stack). 

Unlocked at the start. 

Your basic attack speed booster. Increasing your DPS output by double that of the Mocha, this item is definitely beneficial to stack wherever possible. This item can be applied to virtually every character with massive benefits. The Soldier’s Syringe, however, needs to be stacked constantly as it doesn’t increase base damage, just attack speed. This can take the whole run. Therefore, Soldier’s Syringe is placed at number 13 in this list; a rudimentary item with a very standard use, yet still reliable and consistently useful. 

“Say cheese!” 

12. Will-O’-The-Wisp 

Rarity: Uncommon 

33% chance on killing an enemy to create a lava pillar for 300% (+200% per stack) damage, knocking enemies upwards. 

Unlocked at the start. 

An “on-kill” effect that can kill another, due to its high damage, and stun if not, allowing you to keep attacking. The Will-O’-The-Wisp has the ability to turn around the most dire situations. Much like most uncommon items, the Will-O’-The-Wisp doesn’t require much stacking, as the damage initially inflicted is effective enough at creating a chain of eruptions that will clear most swarms of enemies. Most effective on characters that excel in ‘kiting’, such as Huntress, or perhaps heavy hitters like Sniper, this item is ideal for thinning out the herd when you’re in a particularly tight spot. Although this item is great for clearing swarms of tightly packed enemies, it only ever activates 33% of the time and still only on their deaths, making it a rare occurrence and unreliable unless you can cause huge damage quickly. 

“The ol’ left, right, good night” 

11.  Infusion

Rarity: Uncommon 

Killing an enemy increases your health permanently by 1 (+0.5 per stack). 

Unlocked at the start. 

You can never have enough health, and with the Infusion, you’ll never have to worry about it. This uncommon item provides the player with a permanent plus one to their max health after every kill. Although the increase modifier per stack drops to point five after the first collection, this item’s effect persists for the entirety of the run. It all depends on how many enemies you can take down before you die. This is one of the only items that doesn’t stop giving you a permanent buff without the need for stacking, very dissimilar to the Bitter Root. The Engineer’s turrets now provide the character with this bonus, rather than giving themselves the additional health which can vastly increase the rate at which you gain max health.  

“...ouch…” 

10. Concussion Grenade 

Rarity: Uncommon 

6% (+6% per stack) chance on hitting enemies to stun them for 2 seconds. 

To unlock, kill a boss in 15 seconds or less. 

A deceptively easy unlock in the later stages as it’s common to pick up so many items that bosses sometimes only last for seconds on screen. The Concussion Grenade completely immobilises all targets hit by it allowing the player to ceaselessly go on the offensive but also stops all incoming attacks from the enemy. Stacking this item just increases the chances of activating it, but two seconds is a long time in this game and paired with other on-hit effects like the AtG Missile MK 1 and MK 2, it can be a deadly combination. It also is an extremely versatile item, allowing it to be useful in the hands of any chosen character. Its only real drawback is that it is an uncommon item, making it harder to stack than it probably should be. 

“It’s actually really bad for the knees” 

9. Crowbar 

Rarity: Common 

Deal +50% (+30% per stack) damage to enemies above 80% health. 

Unlocked at the start. 

The Crowbar is a great starting item as it adds bonus damage to enemies with more HP, meaning it also carries its worth in the later stages too when enemies get more frequent and more difficult, possibly staying above that 80% threshold for longer, allowing it to PROC more often. Ideal for the builds that do massive damage extremely quickly, such as Bandit’s one shot - one kill meta, which utilises his special skill to do a huge amount of damage in one shot, instantly killing enemies and thus triggering an instant cooldown of Lights Out. However, this can be a double-edged sword for some characters, as stacking means enemies will drop past the 80% mark much faster and lose the bonus damage modifier equally as quickly. 

“The horrors aside, it's quite scenic” 

8. Harvester’s Scythe

Rarity: Uncommon 

Gain a 5% critical chance. Critical strikes heal for 8 (+2 per stack) health. 

To unlock, use a health shrine until at less than 5% health. 

If the Harvester’s Scythe gets paired alongside the Lens Maker’s Glasses, this item skyrockets in value. Much like the Leeching Seed, the Harvester’s Scythe heals on damage, but only if said damage is a critical hit. Luckily it adds a 5% chance to deal a crit, but this doesn’t make it particularly feasible on its own, what does carry its worth is the sheer amount of healing it does in comparison to the Leeching Seed that grants 2 healing per individual hit. 8 health after a high probability of a critical hit makes it much more viable in the later stages after most likely collecting items that boost the chance of a critical hit, be this via increasing attack speed through the Soldier’s Syringe and Mocha or base critical hit chances with the Lens Maker’s Glasses. 

“Pop! Goes the lizard” 

7. AtG Missile MK 2

Rarity: Rare 

7% (+7% per stack) chance on hit to fire three missiles that deal 3x200% TOTAL damage. 

Unlocked at the start. 

Portable artillery never hurt anyone (except those in the way). Homing shells are released very similarly to the AtG Missile MK 1. Unlike the MK 1, the AtG Missile MK 2 releases three highly damaging payloads with a 7% chance to launch another salvo. When picked up after finding a few MK 1s, the twin items launch the missiles at similar intervals, making for a deadly flurry of seeking projectiles. Perfect for those high DPS characters that might not deal equally high damage, Commando is one of those, so benefits from a complementary boost to its overall destructive power. Regrettably, even synchronised with high DPS to increase PROC chance, this rare item has only a 7% chance to fire, placing it lower on the list compared to the other rare items. 

“Aerial Assualt” 

6. Hopoo Feather 

Rarity: Uncommon 

Gain +1 (+1 per stack) maximum jump count. 

Unlocked at the start. 

The homogeneously named Hopoo Feather allows an extra jump. That’s all. It’s not to be underestimated, though. The extra movement allows any character to keep out of harm’s way or reach a previously inaccessible part of the map, mainly to find map logs or hidden chests that may or may not contain a guaranteed rare item. Whether the selected character is high mobility or sluggish, this item is always applicable with great success. This simple versatility with little to no drawbacks is why the Hopoo Feather is solidly positioned at number 6. 

“High stakes target practice” 

5. Lens Maker’s Glasses 

Rarity: Common 

Your attacks have a 10% (+7% per stack) chance to 'Critically Strike', dealing double damage. 

Unlocked at the start. 

The Lens Maker’s Glasses provide a basic increase to critical strike chance and thus, require a relatively large stack – most productive at thirteen, offering a 94% total increase to overall crit chance. This common item not only doubles base damage when a critical hit triggers but also pairs seamlessly and increases the effectiveness of other critical hit-activated based items, like the Harvester’s Scythe, the Predatory Instincts and the Wicked Ring. Making the Lens Maker’s Glasses infallible when traversing the various stages in the later game when increasing base damage is so imperative. 

“I can see my house from here” 

4. 56 Leaf Clover 

Rarity: Uncommon 

Elite mobs have a 4% (+1.5% per stack) chance to drop items. 

Unlock by defeating the Scavenger. 

In previous iterations of the Risk of Rain games the 56 Leaf Clover was a rare item due to the sheer number of elite enemies that spawned in the later stages. Not only that, but the rate of defeating these enemies became faster the more levels gained and items collected, meaning; that after receiving the 56 Leaf Clover the chance of a random item spawning after their defeat rapidly increased. Now, in Risk of Rain Returns, this same item has been reduced in rarity to uncommon, making it much easier to find and thus stack, which is much needed with only an additional 1.5% PROC chance per 56 Leaf Clover. 

“I’ll just help myself to this” 

3. Repulsion Armour 

Rarity: Rare 

After 6 hits reflect incoming attacks for 400% damage and increase armour by 100 for 4 (+1 per stack) seconds. 

Unlocked at the start. 

What’s better than taking damage? Causing damage. The Repulsion Armour utilises both, reflecting and inflicting quadruple the damage taken after six direct attacks from any source, this rare item also allows much more damage to be taken by increasing the armour value of the player. This allows for almost a guaranteed victory against crowds of lesser enemies and substantial injury to those tougher bosses. Most effective for the tank types of character such as the Enforcer, Loader and HAN-D. 

“This has to be some kind of war crime” 

2. Alien Head 

Rarity: Rare 

Decrease your skill cooldowns by 30% (+30% per stack). 

To unlock, collect 7 Monster Teeth and 1 Guardian Heart in one run. 

An item that allows a blanket cooldown decrease should be coveted at every opportunity. The Alien Head can be unlocked by chance after a few runs but is much harder to find after it’s unlocked due to its rarity. Regardless, it lends itself to every character without fault and allows you to use your skills much sooner. Engineer and Artificer can profit the most from it, after reducing their higher cooldown rates, but it doesn’t go unacknowledged when applied to classes like Commando or Acrid either, allowing them both to become almost twice as mobile and close to doubling their ability usage. The Alien Head massively increases all character’s potential survivability. 

“You better run” 

1. Hermit’s Scarf

Rarity: Common 

10% (+10% per stack) chance to evade incoming damage. 

To unlock, gain 200% attack speed with Huntress. 

At the top spot is a surprising one. A common utility item. The reason being, that it provides a 10% chance to evade any incoming attack or environmental damage. However, it follows the rules of diminishing returns, making it less effective than the item description suggests. As the increasing number of Hermit’s Scarfs are collected, the percentage chance of avoiding a hit is decreased as to remove the chances of the player becoming completely invulnerable by collecting 10. Instead, finding 10  Hermit’s Scarfs creates a 50% chance of not being damaged. Even with this deception, it is still the most desired item due to its flat damage nullification, an effect not found in any other item.

“Pick ‘n’ Mix” 

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