Shotguns are usually used to fire multiple pellets; however, they are capable of firing a single projectile in the form of a slug. Although rare, shotgun slug injuries are severe, producing wounds comparable to those inflicted by high-velocity weapons with the potential for even more tissue destruction because of the slug's size and mass. We report the first survivor of a close range shotgun slug injury, with a review of this weapon's unique projectile ballistics and the relevant literature.