Back 4 Blood Accessories Guide

Last Update: October 29, 2021 6:40 PM


Back 4 Blood Logo Key Art

Back 4 Blood splits its items into several different slots. You have two weapon slots, with one primary and one secondary. There are also three accessory slots: offensive, support, and quick. These complete your kit, with many cards affecting how you use them. The Back 4 Blood Accessories Guide is here to help you choose the best loadout for your build. All cards are presented as they function in Campaign mode.

You can upgrade your accessories by buying the Upgrades from the shop at the start of a mission. Like weapons, they upgrade from white, to green, to blue, to purple. Upgrades include free potential uses and better effects. These Upgrades and extra Slots are good buys, so coordinate your Copper and try to get them when you can. You can only carry one "type" of Accessory at a time. You cannot carry both Defibrillators and Tool Kits, for instance, regardless of how many slots you have. Still, you can enter your Inventory and drop them by clicking.

Back 4 Blood Offensive Accessories

Offensive Accessories include Molotovs, Frag Grenades, Flashbangs, Razor Wire, Pipe Bombs, and Firecrackers. Each has its own utility, but as the name implies these are all throwable items that deal with Ridden directly. Hoffman begins with an additional slot for Offensive Accessories, if you wanted to build around them. To aim and preview where it will affect, hold down the fire button before releasing it to throw.

Back 4 Blood Accessories Pipe Bomb
Pipe Bombs and Firecrackers do serious work in Act 3's The Road to Hell with the endless horde event. Chemical Courage and Medical Expert make guest appearances.


Molotovs set small fires in an area of effect. They deal damage over time and work well in a choke point. Higher rarities improve the burn time and damage. Gas cans and explosive barrels produce a similar effect when shot, making them great boss traps. Molotovs do not affect Charred Ridden. Unlike most other grenades, Molotovs can "bounce" on a surface, so be cool about fire safety.

Frag Grenade

Short, simple, and to the point. Frag Grenades deal damage in a wide radius. The closer to the impact area, the more damage. These are Tallboy killers, so long as they aren’t Ferocious. Beware of friendly fire, though. Upgrades increase the explosion radius and damage.


This truly is the chef’s kiss of throwables. Flashbangs stun and debilitate enemies in a fairly generous radius, causing them to take more damage. These can take out birds, free allies from grabs, and tear through bosses like Hags, Breakers, and Ogres. Someone should always carry at least one of these, especially if you draw a Boss Corruption Card. Since there’s no damage involved, your support party members are probably the ideal candidates. The exception is if they’re running Rousing Speech, which disables Offensive Accessories. Upgrades improve the debilitation effect and radius.

Razor Wire

Razor Wire is circumstantial but very good when it’s relevant. With it, you can cheese defense maps such as defending the jukebox in Act 1. Almost every Ridden is slowed dramatically, making them easy pickings. Otherwise, it’s not very useful when you need to move forward. Upgrades boost the slow and coverage of the wire. Tallboys ignore Razor Wire, and Breakers can destroy it.

Pipe Bomb

Attracts Common Ridden in a radius, then detonates a short time later. Very useful for horde events if you need to thin them out and direct them to an area. See the The Road to Hell screenshot above. Distractions are great! Be wary of friendly fire and Mutations, which will just ignore it. Upgrades boost damage and the timer.


Firecrackers attract Ridden without an explosion. This can be useful if they’re spread out or rushing towards you, as most will turn around and check out the fireworks instead. Upgrades increase the distraction time and radius. Like Pipe Bombs, these aren't particularly useful against Mutations, but they're great for hordes of Common Ridden.

Offensive Accessory Cards

Card Effect
Bomb Squad +100% Explosive Damage, +35% Explosion Resistance
Demolitions Expert +50% Accessory Damage, -15% Ammo Capacity
Double Grenade Pouch +2 Offensive Inventory, -10% Damage Dealt
Fire In the Hole! When throwing an Offensive Accessory, gain 20 Temporary Health and 20% Move Speed for 5 seconds
Grenade Pouch +1 Offensive Inventory
Grenade Training +25% Accessory Damage
Improvised Explosives +75% Accessory Damage, -25% Swap Speed
Offensive Scavenger Sense nearby Offensive Accessories, more spawn
Pyro +100% Fire Damage, Fire Kills grant 3 Temporary Health, sense nearby Flammable Objects
Surplus Pouches -10% Health, +1 Team Offensive Inventory

Back 4 Blood Support Accessories

Support Accessories include Pain Meds, Bandages, and First Aid Kits. As you can imagine, these are geared towards keeping your team up and running. Mom begins with Pain Meds and an additional Support slot, and Doc has a Bandage and bonus 20% Healing Efficiency. Both of them will gravitate towards a healing/support role by default. Hold down the fire button to heal yourself, or the ADS button to heal a close ally. Support Accessories benefit from extra Use Speed and scale off Healing Efficiency. These cannot be used if you are at full health. Doc's Field Dressings scale off of Use Speed and Healing efficiency, but are not considered Support Accessories.

Back 4 Blood Accessories Act 2 Cards
Many of the best Support Accessory Cards are in later parts of the Supply Lines. Chemical Courage/Stimulants changed my life. Be persistent!

Pain Meds

Pain Meds provide Temporary Health, which ticks down slowly over time. They’re also the fastest healing item by far. These jive well with other buffs to reload speed, damage output, and trauma resistance. Works great with a Temporary Health build, since they're very common. Upgrades improve the amount of Temporary Health granted. Pain Meds cannot be reused, and Temporary Health cannot grant you more than your maximum health.


Bandages refill your permanent health and are a midpoint between Pain Meds and First Aid Kits. As you upgrade them, there’s a small chance they can be reused. Assuming your Doc is running a healing build, she’s probably best equipped to use these. They're fairly common, so don't feel bad about using them.

First Aid Kits

Big heals for big ouchies. The First Aid Kit restores the most permanent health but has the slowest use speed among the Support Accessories. Definitely something to drop for your medic. These are somewhat uncommon compared to Pain Meds and Bandages, so you may need to buy them. Higher-quality items gain a reuse chance, heal Trauma Damage, and restore more health.

Support Accessory Cards

Card Effect
Antibiotic Ointment +20% Healing Efficiency
Box O' Bags -10% Health, +1 Team Support Inventory
Charitable Soul When healing another, gain 50% of the healing yourself
Chemical Courage Pain Meds you apply grant +25% Damage for 60 Seconds
EMT Bag +40% Healing Efficiency, -20% Stamina Recovery
Experienced EMT When using a Support Accessory, grant the target 20% more Health until death/the end of the level
Fanny Pack +1 Support Inventory
Field Surgeon +60% Healing Efficiency, -50% Use Speed
Group Therapy Support Accessories you use also heal 5 Health to all teammates
Medical Expert +15% Healing Efficiency, after using a Support Accessory gain 15% Move Speed for 15 seconds
Medical Professional First Aid Kits, First Aid Cabinets, and Defibrillators you use heal 15 Trauma Damage and restore an Extra Life
Miraculous Recovery 25% chance Support Accessories you use have doubled effect
Poultice Allies healed with a Support Accessory slowly regenerate another 20 Health over 30 seconds
Shoulder Bag +2 Support Inventory, -10% Damage Dealt
Stimulants Pain Meds you apply grant +10% Move, Reload, and Swap Speeds for 30 seconds
Support Scavenger Sense nearby Support Accessories, more spawn

Back 4 Blood Quick Accessories

Quick Accessories speed up gameplay in some manner or let you act quickly under duress. They include Ammo Pouches, Tool Kits, Defibrillators, and Stun Guns. Karlee begins with a Tool Kit and a second slot for Quick Accessories.

Back 4 Blood Accessories Inventory
Access your Inventory and click items to drop them. Money, weapons, accessories, ammo, all of it. Except weapon mods, of course. It's a real-time menu, so pay attention!

Ammo Pouch

An Ammo Pouch provides a quick refill on your ammo. This is pretty self-explanatory. There are niche applications for this, such as if multiple people are running the same ammo type and cannot (or will not) share. If you chew through a lot of ammo, hold one if you find it. Better quality Ammo Pouches restore more ammo.

Tool Kit

Tool Kits have several different applications. The first, obvious one is to open the stash doors (marked with a yellow symbol). They’ll always have at least something good, whether that’s extra Copper, weapons, attachments, or even just a First Aid Cabinet. Tool Kits can also bypass some obstacles such as winches, or start a combine to cut down tall stalks of corn. Carry one or two of these, but not everyone needs them.


These act as a near-instant revive, like Mom’s special ability. It can even revive dead teammates, which can turn the tide in a pinch. Coupled with Medical Professional, rarely will an ally stay down or dead for long. If you’re running a medic build, these become much more useful.

Stun Gun

Break out of a pin or stun an enemy in front of you. Essential for melee combatants if they aren’t Evangelo or running Breakout. Get out of Hocker spit, Crusher grabs, and even the Hag trying to eat you. Take advantage of the reprieve to delete them from the map. Decent pick if you plan to take aggro on an upcoming Hag.

Quick Accessory Cards

Card Effect
Medical Professional First Aid Kits, First Aid Cabinets, and Defibrillators you use heal 15 Trauma Damage and restore an Extra Life
Utility Scavenger Sense nearby Quick Accessories, more spawn


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More Info About This Game
Learn more about Back 4 Blood
Game Page Back 4 Blood
Release Date
October 12, 2021 (Calendar)
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