If the player falls a long distance in Hexen, he will scream before the impact, which is usually fatal, although there is a range at which a player may scream but not be guaranteed to die. There is also a special case in the connection between the Dungeons and Effluvium where the player plummets down a drop, triggering the scream, but is "rescued" by a script to change levels before the impact occurs. Extreme falls in Hexen (2047+ units of uninterrupted freefall) can kill even if the Icon of the Defender is being used or the God mode cheat is on, and play a gory bone-shattering sound rather than the character's usual death or gib sounds. 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 if the player manages to activate them before hitting the ground.
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. ZDoom introduced its own optional falling damage formula before implementing support for Hexen and Strife.