Lil' Dumpy is a passive item.
- Grants a Dumpling familiar that loosely follows the player, moving around the room randomly. Farts when hit by anything damaging, sending it bouncing around the room.
- Farts have a chance to briefly stun or poison enemies.
- BFFs! - Increases the size of Lil' Dumpy, allowing it to more effectively poison groups of enemies.
- Giant Bean - Lil' Dumpy's farts will deal extra damage and stun enemies.
- Lighter - Lil' Dumpy's farts become explosions and leave behind a fire. The explosions can hurt Isaac.
- When attempting to collect Knife Piece 3, Lil' Dumpy can destroy fire that needs to stay lit.
- ZV4B FD4N (First floor treasure room)