The basic edition contains eleven characters, their starting items, 107 monster cards, 104 loot cards, 105 treasure cards, 3 bonus soul cards for advanced play, a six sided die, an eight sided die, 100 pennies, and the rulebook.

The Kickstarter ended with 38,335 backers pledging a total of $2,650,875.

The Kickstarter, revealing that this was a card game, was launched two days later within only a few hours of the launch of the campaign, the project was successfully funded, receiving its goal of $50,000 within the first 1.5 hours. Leading up to the Kickstarter in June 2018, McMillen had teased a new Isaac-themed game, and named it on June 25, 2018. McMillen was wary, knowing that digital-based Kickstarters could fail, but agreed to using it as long as they had a nearly-ready product to be sold at the start of the Kickstarter, and that he could expand on the game by adding new cards when extended Kickstarter goal tiers were met. Studio71 had suggested the Kickstarter route for gaining funding for the game, as they had used that successfully for Joking Hazard. After prototyping enough of the game for about two months, he recontacted Studio71 to work out the fuller details for the game. About a year later, McMillen had gotten the flu, and during his off-time, came up with a card game variant for The Binding of Isaac. At that point, McMillen was still focused on developing The End Is Nigh and The Legend of Bum-bo, and declined the offer. The game started development around 2017 when Studio71 US approached McMillen Studio71 was in the process of making the Cyanide & Happiness card game, Joking Hazard, and had asked McMillen if he was interested in a board game variant of The Binding of Isaac. They also deactivate their character, and any activatable items they control. If the player dies, their turn ends, and they discard an item, a loot card, and 1¢. If the monster is a boss, the player gains soul(s) in addition to these other rewards. If the player manages to kill the monster, they will gain certain rewards such as loot or money. Depending on the number, it will either attack the monster or miss, resulting in either the monster or player taking damage, respectively.

To attack, the player must roll a number greater than or equal to the die value listed on the monster card. Each monster battle is handled differently, with some having counters, and some denying certain number rolls. On a player's turn, they may buy one item from the shop for 10¢, attack a monster, and play one loot card. Loot cards and treasure items are used to aid in attacking enemies and gain advantages over other players. Each player picks a character at random along with their starting item, 3¢, and 3 loot cards. The game has similar rules to Magic: The Gathering.

The binding of isaac four souls