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When hanging one's self, the subject uses some type of ligature, as in a rope or a cord, to form a noose (or loop) around the throat, with the opposite end secured to some fixture. Depending on the placement of the noose and other factors, the subject strangles or suffers a broken neck. In the event of death, the actual cause often depends on the length of the drop; that is, the distance the subject falls before the rope goes taut.

In a "short drop", the victim may die from strangulation, in which the death may result from a lack of oxygen to the brain. The victim is likely to experience hypoxia, skin tingling, dizziness, vision narrowing, convulsions, shock, and acute respiratory acidosis. One or both carotid arteries and/or the jugular vein may also be compressed sufficiently to cause cerebral ischemia and a hypoxic condition in the brain which will eventually result in or contribute to death. Hanging survivors typically have severe damage to the trachea and larynx, damage to the carotid arteries, damage to the spine, and brain damage due to cerebral anoxia.

In a typical "long drop", the subject is likely to suffer one or more fractures of the cervical vertebrae, generally between the second and fifth, which may cause paralysis or death. In extremely long drops, the hanging may result in complete decapitation.