Wounds caused by contact shots are devastating, as the body absorbs the entire discharge of the cartridge, not just the projectile. In this case the injection of rapidly expanding propellant gasses may cause significantly more damage than the bullet itself. Even a blank cartridge can very easily cause lethal wounds if fired in contact with the body, so powerheads, which are intended to fire at contact range, are still very effective when loaded with blanks^{[citation needed]}, while being relatively safe if accidentally discharged from a distance.

Firearms such as muzzleloaders and shotguns often have additional materials in the shot, such as a patch or wadding. While they are generally too lightweight to penetrate at longer ranges, they will penetrate in a contact shot. Since these are often made of porous materials such as cloth and cardboard, there is a significantly elevated risk of infection from the wound.

In the field of forensic ballistics, the characteristics of a contact shot are often an important part of recreating a shooting. A contact shot produces a distinctive wound, with extensive tissue damage from the burning propellant. Unlike a shot from point-blank range, the powder burns will cover a very small area right around the entry wound; often there will be a distinct pattern, called tattooing. Star-shaped tattooing is often caused by the rifling in the gun barrel, and distinct patterns may also be made by flash suppressors or muzzle brakes. The shape of the tattooing may help identify the firearm used.

In many cases, the body's absorption of the muzzle blast will act as a silencer, trapping the propellant gases under the skin and muffling the sound of the shot.

• Captive bolt pistol, a device designed to stun livestock with contact shots

• Perdekamp MG, Braunwarth R, Schmidt U, Schmidt W, Pollak S (2003). "[Contact shot from infantry weapons with a flash-suppressor]". Arch Kriminol (in German). 212 (1–2): 10–8. PMID 12951720.
• Perdekamp MG, Schmidt U, Rupp W, Braunwarth R, Rost T, Pollak S (April 2005). "Contact shot with unusual soot pattern". Forensic Sci. Int. 149 (1): 75–9. doi:10.1016/j.forsciint.2004.06.035. PMID 15734113.
• Rothschild MA, Maxeiner H (1994). "Unusual findings in a case of suicide with a gas weapon". Int. J. Legal Med. 106 (5): 274–6. doi:10.1007/BF01225420. PMID 8068574. S2CID 22841782.
• Chest Injury in Close-Range Shot by Muzzle Loader Gun: Report of Two Cases