|“||I'm sorry, Beth...I have no choice. It's the only way I can survive anymore. If someone finds this, I'm sorry, I had to...I had no choice.||„|
|~ Hannah's journal|
Makkapitew was the leader of the Wendigos, a monster dwelling within the mountain wilderness. The Stranger's grandfather made it his life's career to kill the creature, but was unsuccessful, and died in the process. When mining began on the mountain, the mountain apparently "cried out," and a cave-in unleashed other Wendigo spirits.
The Stranger dedicated his life to hunting the Makkapitew, and after many years had passed, finally tracked it down, as it lurked near the Washington residence.
It stalked after Hannah after she left the residence, Beth shortly following after. The Makkapitew had them cornered at the cliff, where it forced them off the edge. The Stranger then caught up, and instead of capturing the Makkapitew he killed it with his flame thrower in order to avenge his grandfather and the girls. The Makkapitew formerly possessed an unknown Native American person until being incinerated by the Stranger as evidenced by it wearing feathers.
It is heavily implied that Hannah became the next host of the Makkapitew when she resorted to canabilism while trapped in the mines.
When Hannah's friends returned to the Washington residence, as the Makkapitew she started stalking them, partially out of natural instinct as a Wendigo and partially out of revenge for what happened to to her the year prior.
Though it is said that Wendigos forget all about their lives as humans, if Josh recognizes the tattoo on the Makkapitew as Hannah's and calls out to her, she will spare him instead of breaking his skull.
As Hannah, in most endings, the Makkapitew is killed again when the Washington residence explodes.
It is very possible that if in the ending where Josh survives he becomes the next Makkapitew, though there isn't enough solid evidence to say for sure