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Falling damage is a hazard incorporated in Hexen and Strife. When a player falls from an unsafe height, he will be injured in proportion to the distance fallen. If the player falls from a deadly height in Hexen, he will scream before impact and will die upon hitting the floor, even if the God mode cheat is on. Hexen's falling damage is applied to enemy creatures as well, so pushing a non-flying monster over a precipice (such as with a Disc of Repulsion) is a potential method of killing it.

Wings of Wrath and the Chaos Device are useful artifacts for escaping a deadly fall.

Vanilla Doom does not model falling damage; neither the player nor monsters are injured as a consequence of falling from any height. The game nonetheless recognises when a player has fallen a significant distance, playing the sound effect DSOOF. (The sound effect is played when the player hits the floor with z momentum less than -8. At the start of a fall, the z momentum is set to -2. Each game tic, the z momentum is added to the z position, and -1 is added to the z momentum. For z momentum to be less than -8, the player must fall for at least eight tics, which corresponds to a fall of 44 map units.)

Some modern source ports, such as ZDoom, allow optional falling damage in other Doom engine games as well.