The heatsink includes all of the necesarry items to get you set up except a fan. You must provide your own. This gives you the choice of fan for your heatsink, so you can get exactly what you want. Performance, silence, or a fan that gives you fair performance that is on the quiet side. Moving on to the included items, you'll find just the bare necessities.
2) AMD K8 Retention Clip
3) 2x 92MM Fan Clips
5) Thermalright Sticker
6) Thermalright Thermal Paste
The manual is very simple, yet effective. It's only a single side of a piece of regular sized paper, but it gets the job done and tells you how to properly assemble and mount the heatsink. For mounthing, Thermalright decided to stick with AMD's stock retention clip with this heatsink, vs. a custom styled P4/s478 one for the XP-90, so no chance of using this heatsink on your CPU if you removed your IHS, or if your CPU lacks one. Though it can be a bad thing for owners that have CPU's without IHS', the stock mechanism usually makes the installation simpler, and less timely. A large tube of thermal paste is included, vs. a pre-applied thermal pad. The tube will be enough for probably 8-9 mountings or more. Most enthusiasts prefer paste over a pad, because it offers a more custom application for better contact for everyones individual and unique CPU. Appearence
The first thing you'll notice with the Ultra-90 is it's large size. This can pose problem for users with SFF rigs, or smaller sized ATX cases. Albeit its very large, you'll most likely be OK if you have a regular sized ATX case, or even some M-ATX cases. Looking at the rest of the heatsink, you'll realize Thermalright paid close attention to detail. If you look at the top of it, you'll see the embossed Thermalright logo, a nice touch. When looking at it from the side, you'll see the fins are bent slightly, to reduce air resistance and to direct air down towards your RAM/Mosfets, or up, towards your cases exhaust fan.