A reflective pulsed terahertz imaging system based on direct detection was developed and used to obtain high-resolution images of a porcine skin specimen with superficial partial-thickness (second-degree) burns. Images were also obtained of the sample through ten layers of dry medical (cotton) gauze with minimal image degradation. The burned and unburned regions of skin had large differences in terahertz reflectivity, displaying clear delineation [20 dB signal-to-noise ratio (SNR) difference signal] between both regions in the images. The terahertz images also exhibited a "halo" surrounding the burn areas that may correlate to the extent of burn injury. The system operated at a center frequency of 500 GHz with 125 GHz of 3 dB bandwidth and used whiskbroom scanning to generate images with a spatial resolution of 1.5 mm. Each pixel was acquired with a 16 ms integration time, resulting in a 40 dB postdetection SNR. The simplicity and high SNR of the reflective terahertz system are promising steps toward real-time terahertz medical imaging.