Once exposed to another organism, the virus begins mutating its host. The host becomes extremely aggressive and seemingly mindless as it attacks any living thing in sight. Geologist Fifield was exposed to the pathogen during the USCSS Prometheus' expedition of LV-223, mutating his appearance and causing him to attack his fellow crew members. He was also extremely resistant to physical injury, being able to withstand multiple gunshots. It took several shotgun blasts, being scorched with a flamethrower and ran over twice with an RT Series Group Transport to finally kill him. The pathogen also mutated several worms found in the Engineer temple, turning them into the aggressive Hammerpedes. The Hammerpedes exhibited acidic blood and the ability to regenerate lost body parts, though the latter is an ability commonly found in Earth worms. However, the regeneration of Hammerpedes is much faster than that of normal Earth worms, suggesting that the pathogen can enhance a host's natural abilities.
Charlie Holloway was also exposed to the pathogen and began mutating before Meredith Vickers killed him to prevent the virus from coming aboard the Prometheus. The virus appeared to affect his reproductive system. Prior to his physical mutation (while carrying the virus), Holloway had sexual intercourse with his lover, Elizabeth Shaw, impregnating her with the Trilobite. It is not known if his sperm was mutated causing an abnormal conception or if he was simply carrying a Trilobite that moved into Shaw, though the latter seems more probable given that Shaw was sterile. Whether Trilobites prefer to move into female subjects or if Holloway would have naturally given "birth" to the Trilobite is unknown. Although Shaw was exposed to the infected Holloway and had sex with him, she was not infected with the liquid and only received the Trilobite embryo. This suggests that the Black Liquid itself is not sexually transmitted, but it affects the host's reproductive system.
It was shown that the Engineers created the chemical thousands of years ago on LV-223 for the purpose of wiping out entire planets. Somehow, the Engineers themselves were exposed to the pathogen, wiping out the entire Earth invasion force, except for one still in stasis.
In 2093, the USCSS Prometheus came to explore LV-223 after finding clues of the Engineers' existence in ancient cave drawings on the Isle of Skye and in the archeological sites of many other unrelated ancient Earth civilizations. A few crew members were exposed to the pathogen, and in the ensuing chaos most were killed. The remaining crew later sacrificed themselves and the Prometheus to destroy the Engineer's ship, with Elizabeth Shaw and the android David as the only survivors leaving aboard another abandoned ship to head for the Engineer's homeworld.
- At the start of Prometheus, an Engineer is shown to drink a similar-looking liquid which causes his body to disintegrate into DNA. It is unknown whether or not this liquid was the black liquid.
- Unrefined Royal Jelly has the same effect, if not more powerful, as the black liquid, when in contact with non-Xenomorph life.
- Refined Royal Jelly and Xeno-Zip that humans fix has similar effects as the black liquid on humans in the movie Prometheus, except it didn't cause DNA disintegration. The person taking Xeno-Zip would become extremely strong and have a massive resistance to pain, to the point that even having limbs torn off will not stop the user. The one effect Xeno-Zip causes that Royal Jelly does not is madness which, ironically, it shares in common with the black liquid.