Gunshot wounds result in a great amount of tissue damage, relating almost always to fractures and defects of the skeleton. The damage varies in relation to the speed, size, shape, and striking angle of the projectile and to the disruption of hard tissue fragments, which multiply the tissue laceration acting as secondary missiles. The rules to be observed in treatment of gunshot wounds are based on experience which was gained during World War I and II. Most of the rules have proved to be a success and may be summarized as follows: approach from inside to outside, preservation of the anatomical relationships of the remaining bony tissues, and primary wound closure. On the other hand, considerable progress has been made concerning reconstruction and establishing a number of new methods in order to create better functional and esthetic results.