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Tarot Cards are a consumable item the player can find in the game that are based on an actual real life set of cards. There are 22 different Tarot Cards in the vanilla game and an additional 5 cards (that looks like regular deck cards) in the Wrath of the Lamb expansion.
Possibly the worst card in the game as it only teleports the player back to the floor's starting room. Using this card can still spawn the Krampus mini-boss, so be prepared for a potential fight. Ace Of Spades - A trinket that increases the chance of finding deck cards (the Tarot Cards added in the Wrath of the Lamb expansion).
The only use I can think of when it comes to this card is to get out of un-leavable rooms such as Challenge Rooms or the Mom boss fight. This card will target a random enemy in the room, but if no enemies are present it will target Isaac instead.
This is useful for when you want to get into a shop but don't have a key, but be warned that if used on a floor that doesn't have an Item Shop this card will act as a random teleport instead. If you have the Wrath of the Lamb expansion installed this card can spawn a Fortune Telling Machine instead.
The best way to use this card is in rooms with lots of monsters or against bosses that like to spawn adds.

Be careful when using this card as the bombs can push themselves into you when they explode.
A random wall will be opened inside the Secret Room allowing you to exit even if you don't have any bombs. This card will fully reveal the map including icons (will not reveal the Super Secret Room), damage all enemies in the room, and fully heal the player. This item acts as a combined effect of the Compass and the Treasure Map items, and as such is useless if you already have both.
It is important to note that if you use this card and then find the Devil Room normally (by killing the boss), you will still see the same items (or none if you took them on your first visit). Exiting the Devil Room after using this card will take you back to the floor's starting room. This means that if you have 5 Red Heart containers but only 2 of them are filled, after using this card you will have 4 filled containers.
If you learn cartomancy then you have to look, which cards are next to the marriage card to find out in which situation the binding is. As such, you can only carry one pill or Tarot Card at any given time; picking up one of these items while already holding one will cause Isaac to drop his current item. The key difference between Tarot Cards and pills is that the effect of a Tarot Card is always the same.

Because of the way champion enemies are picked, this card can be used to "re-roll" the Boss and try to get a champion version. The best place to use this card is in an Angel or Devil room since any item gotten from the Beggar will be rolled from the room's possible drops (ie. As such you should first kill the Boss and see if the Devil Room spawns normally before using this card or you may end up wasting it. If used and Isaac only has half a heart left it will fill your first two Red Heart containers. Everything that was here will still be here so please be patient while we get through this time. If you stumble upon this card try to save it for the later floors so you can skip all of the hard rooms and go straight to the boss.
The best way to use this card is for Boss or Challenge rooms, but it can also be used to get an extra health boost when you are going to die.
If the current floor does not have a Treasure Room this card will act as a random teleport instead.

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