Zircon (U-Th)/He (ZHe) thermochronometry quantifies the timing and tempo of low-temperature processes and is used to deconvolve tectonic and erosional histories. Accumulation and annealing of radiation damage impacts He diffusion in zircon and resulting ZHe dates. Resolving complex histories requires building relationships between ZHe date, effective U (eU), and radiation damage in grains sharing a common thermal history. Prior work demonstrated that purposefully selecting grains with a spectrum of visual metamictization yields a broad range of intrasample eU values (Ault et al., 2018), but it remained unclear if visual metamictization tracks effective radiation damage. Here we evaluate relationships between visual metamictization, effective damage calculated from Raman spectroscopy, and ZHe dates from a new suite of grains from some of the same Precambrian samples investigated in Ault et al. (2018) and Phanerozoic detrital grains from Armstrong et al. (2022). New ZHe analyses (n = 21) confirm increasing visual metamictization corresponds with increasing eU concentration and dates fall along previously reported ZHe date-eU trends for each sample, despite grain selection by different analysts in different sessions. Raman-based alpha dose calculations from multiple spot analyses from transects across the surface and interior of each grain (n = 480 total analyses) range from 3.19 × 1016 to 1.52 × 1019 α/g across the whole dataset. Alpha dose increases in samples characterized by a clear increase in visual metamictization from different types of ZHe date-eU patterns, supporting that visual metamictization reflects effective radiation damage in these samples. Complexities in visual metamictization-damage trends are due to damage zonation observed in cathodoluminescence, comparative internal and external spot analyses, and 2-D Raman maps, as well as limited spread in intrasample visual metamictization and user grain selection bias. Overall, visual metamictization provides a qualitative estimate of effective damage and should be leveraged when selecting grains for traditional ZHe analyses to build ZHe date-eU-damage patterns.