The injury pattern of shotgun wounds is significantly more extensive and severe compared to wounds caused with conventional handguns. At close range, the destructive force of a shotgun compares with that of a high-powered rifle. The typical contact and near-contact range shotgun wound in areas except the head measures the approximate diameter of the gun's barrel. Marginal abrasion of the wound, similar to that of a single bullet gunshot wound, occurs as the shot penetrates the body in a mass of pellets. The wound edges are blackened by gun smoke. Inside the wound, abundant soot and gunpowder can be identified by granularity of the tissues. In the heart area, massive bleeding may wash out most powder residue. In close-range shotgun wounds, the pellets will likely reach the target as a single mass when fired from a distance of 4 to 5 feet. The pattern made by a shotgun from a distance of over a few feet varies with the choke, length of the barrel, powder load, size of shot, and gauge of the gun. It is further modified by varying design of the inner liner within the shotgun shell. This chapter also discusses the features of shotgun exit wounds, which are uncommon even in contact or close-range shots, except if the shot involves the head or if the victim is very thin. In headshots, the entire head may be shattered, and all pellets and the wad may exit. Other sections of the chapter address the survivability of shotgun wounds and the damage that can be caused by shotgun beanbag ammunition. Extensive photographic illustrations and 3 references