Damage reflection causes a portion on the damage dealt to a target to also be taken by the attacker.
- Rare monsters can receive an affix that gives the monster a damage reflection aura. There are two such auras, one that reflects 15% of physical damage and another that reflects 15% of elemental damage.
- Some affixes that appear on maps give all monsters in that map a damage reflection modifier, either physical or elemental.
- A monster dealing physical damage with an attack while cursed with will have a portion of that damage reflected back on themselves.
- Damage Reflection can be personally acquired by a Damage Return Item Affix seen almost exclusively on Shields. Summoner type players that use Necromantic Aegis should consider using a Shield with a high amount of high damage reflection for additional synergy as this effect spreads to all Minions.
- There is currently one Reflect Damage Skill: Tempest Shield, which occurs upon Blocking with a Shield.
The dangers of damage reflection
Reflection can be one of the most dangerous effects to encounter at high levels, especially for players focused on high damage output and attacks or spells which can hit many targets at once. A fast moving rare monster that appears quickly from off the screen and affects multiple monsters with its reflection aura can cause a large spike of damage to the player. Players must also be careful with skills that have a long duration (such assupported by and ), as once cast, they cannot be cancelled if a source of reflection appears.
Long-range attacks and spells can also be dangerous, as stray arrows and spells might hit a tightly packed group of reflection monsters that are off-screen, causing a large amount of damage to the player.
Even monsters that are much lower level than the player and would normally pose no threat can prove deadly if affected by reflection, since the reflection is based on the player's damage output, not the monster's damage.
Reflection auras can sometimes be difficult to spot, especially in the heat of battle when the aura can be obscured by various skill effects, and other auras.
Dealing with reflection
- Reflected damage can be reduced by the attacker's Armour and resistances. For instance if a player with 50% lightning resistance deals 500 lightning damage to a monster with 20% elemental damage reflection, the player will take 50 reflected lightning damage.
- If the reflected damage is attack damage, it can be evaded. It uses your own accuracy rating. 
- Damage dealt by a player's totems, traps, mines, and minions will be reflected back to the totem/trap/mine/minion, not the player.
- A rare monster with a reflection aura can be converted, giving the player and the player's allies the benefits of the aura instead of the surrounding monsters.
- Having at least one skill that deals primarily physical damage can be useful for killing monsters with elemental damage reflection, and vice versa.
- There are no effects that reflect Chaos damage, making it useful against both types of reflection.
- Damage from degeneration effects such as burning is not reflected.
- Sufficient amounts of Life Leech can lessen or completely counteract the damage from reflection.