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Full-contact fighting appeals to participants who want to engage in realistic combat with an opponent. Competitions tend to be more aggressive and may have few rules or almost no rules except the imperative to physically defeat the opponent. In general, competitors have more freedom in full-contact as opposed to medium-contact fighting, though often there are some techniques, such as biting and attacking the eyes or groin, which are forbidden. A point or time system may or may not be used, as this would interfere with realistic combat. The term 'full contact' may also refer to the limitation of protective gear. As an example, kyokushin, a variant of karate, allows participants to wear no more protection than a groin guard while sparring.

Depending on the rules, full-contact fighting may allow participants to use full force to disable or knock out an opponent or achieve submission. At its extreme, the term 'full contact' may mean that all techniques of attack are permitted and that no zones of the body are forbidden from attack. In the early UFC events, judges, time limits, and points were not used. The outcome of a competition was determined by the inability of one of the participants to continue. In Portuguese, vale tudo, which means 'anything goes,' is a form of full-contact fighting. Full-contact rules are used in almost all mixed martial arts competitions held by the UFC, PRIDE, Pancrase, and Shooto. Recently, however, safety rules were written and the use of protective gloves was added. Brazilian Jiu-Jitsu and judo, which do not allow striking, are still full-contact fighting in that full force can be used during grappling and submissions. Sambo has full-contact variations of its fighting system.

Some practitioners of full-contact, hand-to-hand combat believe that physically defeating the enemy is the only goal in a competition. Winning a sports match by rules does not appeal to them. They treat competition in the martial arts as a matter of life and death, and they pursue training and the study of fighting techniques without regard to competitive rules or ethical and legal concerns. Even so, with precautions such as a referee and a ring doctor, full-contact matches with basic rules can serve as a useful gauge of a practitioner's overall fighting ability and encompass striking, grappling, holds, and other broad categories.