The Binding of Isaac: Rebirth: The Binding of Isaac: Afterbirth

At launch, the game closed on start for some players with the DLC enabled, crashed when entering the Blue Womb after It Lives, and imported Rebirth saves with scrambled completion marks or achievements players had not earned. Bugs, crashes or glitches come up in 13% of the longer reviews overall and in 23% of those from the month after launch day. Some players briefly thought their saves were gone until others pointed to the import button ("For those that are saying your save files are gone, there is an import data option on the file selection screen."), while others warned, "Do not import your save without backing it up first." Patches fixed some of this within weeks, and a few critics edited their reviews to say so. One reviewer only flipped a negative vote much later: "I cannot believe I had an oudated negative review sitting here for almost a year based on a problem that was resolved long ago." Launch failures never fully went away, though. 37 reviews written from 2016 onward still describe crashes or a game that will not start, some of them right after a DLC was installed, for example "GAME WILL NOT OPEN AFTER INSTALLING AFTERBIRTH PLUS." and "Buying all the dlc reset my save file".

Players name Azazel's attack, Lilith's Box of Friends, the Stopwatch and Judas's Book of Belial, and several argue a single-player game does not need nerfs at all: "they keep nerfing crap and apparently NO FUN ALLOWED". Nerfs come up in 6% of the longer reviews and 24% of the longer negative ones, and 90% of those mentions date from 2015. The lack of patch notes added to the anger, because players learned of a change only by picking up an item that no longer worked: "There have never been any patch notes for this." One reviewer added, "I still hold a grudge on the stopwatch nerf". A few defended the changes as necessary once the new synergies made some builds too strong.

Part of the advertised item list and the second new character were missing for the first days and were patched in over the following weeks, and 4% of the longer reviews (15% of the longer negative ones) say the expansion was incomplete at launch. Some players enjoyed the community hunt for secrets around launch; others felt the missing content should have been stated on the store page: "this was not a complete product on launch." The promised new final area also disappointed people who expected a full floor: "The new chapter/area is a tiny prep room and a single boss room."

Some owners find the game still launching as Rebirth, or Steam listing the DLC in the library but not installing it, or Steam refusing Afterbirth+ and Repentance because it no longer recognizes Afterbirth: "it sucks i have afterbirth and its not letting me get afterbirth+ or repentence". Problems getting the content to run or to count come up in 4% of the longer reviews and in a steady trickle of short ones across the later years. Others report being told to buy again ("need to re-purchase if i want to play repentance or repentance+") or object to the later expansions being sold only as a bundle. A few Mac and Linux owners add that later expansions dropped their platforms, leaving them stuck on Afterbirth. From Repentance's launch onward, 42% of the negative reviews (35 of 84) are about launching, crashing, mods or Steam purchases, against 17% (14) that criticize the content itself.

3% of the longer reviews, and 10% of the longer negative ones, complain about room design that makes damage unavoidable: tiny, narrow and L-shaped rooms holding big bosses, enemies that spawn on top of Isaac, item pedestals fenced in by spikes, and devil deals that spawn outside a small boss room where they cannot be reached. One player put it sarcastically: "I'm sure everyone asked for smaller rooms that make enemies more difficult to dodge."

The Keeper is the secret character unlocked by feeding 1,000 coins into the Greed machine. He heals only with coins, holds at most two coin hearts and cannot use devil deals, and his own unlocks are described as weak. He comes up in 3% of the longer reviews, and the reviewers who judge him mostly dislike playing him: "the secret character is horribly unfun." Another reviewer wrote, "Keeper is broken, plain annoying to unlock, and rewards suck."

Weak, situational and joke items crowd out the strong ones, say 3% of the longer reviews, so good runs come along less often, and new pill effects make unknown pills riskier: "It dilutes the already existing pool with 120 more items, some great, some trash."

The store lists multiplayer and co-op, but co-op is local only and the second player joins as a familiar ("they should only have the local co-op tag"). Co-op comes up in 2% of the longer reviews, and the other complaint is about rewards: many unlocks, including the rewards for beating Mega Satan, are new co-op babies that solo players never use: "Dozens upon dozens of disgusting and awesome babies that the vast majority of players will never even see in action".