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The Spear is given to the Nerevarine as a reward by Sheogorath for completing his quest.
Sheogorath, in a typical display of his enthusiasm in the eccentric, will task the Nerevarine with killing a Giant Bull Netch with a Fork. Once the Bull is dead, the Nerevarine may return to Sheogorath's adopted shrine of Ihinipalit (in the St. Delyn Canton in Vivec) to exchange the Fork of Horripilation for the Spear of Bitter Mercy, as a reward.
During the events of The Elder Scrolls III: Tribunal, the Nerevarine may seek out Torasa Aram of the Museum of Artifacts in Mournhold. She will offer the Nerevarine 30,000 for the Spear, the maximum amount the Museum will spend on any object, which will then go on display in the Museum. The Nerevarine may also donate the Spear.
- In An Elder Scrolls Legend: Battlespire, the Spear is associated with Hircine.