In the main event, Mickie James defeated Jordynne Grace to win the Impact Knockouts World Championship in a Title vs. Career match.

On October 7, 2022, at Bound for Glory, it was announced that Hard To Kill will take place on January 13, 2023, at the Center Stage in Atlanta, Georgia.

[6] At Bound for Glory, Bully Ray returned to Impact Wrestling in the Call Your Shot Gauntlet, last eliminating Steve Maclin to win a championship match at the time and place of his choosing.

[13] After suffering a defeat from Chelsea Green on the July 14, 2022 episode of Impact!, Mickie James would leave the arena to return home, emotional and unsure about her future in professional wrestling.

Later on the main show, reigning champions Heath and Rhino successfully defended the titles against The Major Players (Brian Myers and Matt Cardona).

[26][27] On the December 8 episode of Impact!, Heath and Rhino defended the titles against The Motor City Machine Guns, but the match went to a no contest due to interference from The Major Players.

[23][24] The week after, The Motor City Machine Guns announced that they will defend their titles against Heath and Rhino, The Major Players, and the team of Austin and Bey - who recently made it to the finals of the Super Junior Tag League in New Japan Pro-Wrestling - in a four-way tag team elimination match at Hard To Kill.

[13] On December 29, Impact announced a three-way match between Deonna Purrazzo, Masha Slamovich, and Taylor Wilde to determine the next number one contender for the Knockouts World Championship.

[31] On the December 1, 2022 Impact!, Moose cut a promo after defeating Bhupinder Gujjar, saying he knew what Bully Ray's true intentions with the Call Your Shot Trophy were.

[32] On January 6, Impact announced that on Countdown to Hard to Kill, the pre-show of the event, the Impact Knockouts World Tag Team Champions The Death Dollz (Jessicka, Rosemary and Taya Valkyrie) will face Gisele Shaw, Savannah Evans and Tasha Steelz in a non-title six-Knockouts tag team match.

[33] On the December 22, 2022 episode of Impact!, top world title contenders Rich Swann and Steve Maclin faced off in a match that ended in a double countout.

[34][35] On the January 5, 2023 episode of Impact!, Swann challenged Maclin to a rematch, this time a Falls Count Anywhere match at Hard To Kill, which was made official later in the night.

[39] The main event of the pre-show saw Trey Miguel defend the Impact X Division Championship against Black Taurus (with Crazzy Steve).

[39] The opening constest was a Full Metal Mayhem match for the Impact World Championship between Josh Alexander and Bully Ray.

Moose initially won after a low blow and a spear, but Santino Marella made his debut as the Director of Authority, and announced that the match will be restarted.

[39] Next, Masha Slamovich, Killer Kelly, Deonna Purrazzo and Taylor Wilde squared off to determine the #1 contender to the Impact Knockouts World Championship.

[39] In the main event, Jordynne Grace defended the Impact Knockouts World Championship in a Title vs. Career match against Mickie James.