???'s severed head.
- There's a 50% chance when you start a new game session that determines if Fate can be found at all during the session. If Pyro appears in the Secret Room then Fate is definitely in the game for that particular run.
- This item is most likely called "Fate" as a reference to the fact that Isaac eventually turns into ???.
- The sprite is actually from Edmund's 'DeadBaby VG Dressup' game on Newgrounds. It appears on the Dead Baby and in the background of the loading / menu screen.
- The fact that this item is only found in Golden Chests may be a reference to Ending 10 and The Chest, where Isaac finds ??? in the chest.