Bruising is one of the earliest, most common, and easily recognizable signs of physical child abuse and can signal escalating interpersonal violence within a household. Early detection of abuse through recognition of bruising coupled with appropriate intervention may help to prevent future and potentially more severe physical assaults. This article provides an overview of precise terminology and definitions, contusion pathology, development and appearance of bruises, characteristics of bruises suspicious for abuse, photographic documentation, techniques to help visualize bruising, conditions that may be confused with abusive bruising, and the difficulties encountered when attempting to estimate the age of bruises.