???'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 run. Therefore, it is completely up to the system to decide whether the item can be obtained throughout the run.
- If Pyro appears in the Secret Room then Fate is guaranteed to appear 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.
- When Kamikaze is picked up Isaac no longer has Angel Wings, but is still able to fly as usual.