In Quake 4, the Quad Damage Powerup only multiplies damage by three, making it less powerful than its forefathers. The Quad Damage Powerups can only be found in Multiplayer mode and they are not common. Sometimes they are removed for balancing reasons, due to unfairness to the players, even though the damage multiplier is down to 3. When picked up, the player is surrounded by a blue aura, making her or him easily spotted by other players, and sometimes in deathmatch, the Quad Damage owner will be everyone's target. However, with quad damage, it will be much easier versus enemy player with Megahealth or Heavy Armor.

The damage value can be modified by /g_quadfactor in the console. The default is 3 so if the player types in /g_quadfactor 100, the weapons damage will be multiplied 100 times when the Quad Damage is being held. In the same way, if the player types in /g_quadfactor 0 for example, his/her weapons will not do any damage at all.

In Team games the player glows the color of their respective team. When they are killed, the Quad Damage will disappear instead of being dropped for the next person to pick up.