Background : Due to the increase of weapons, fire arms, and violence in several Arabic counties affected by the “Arabic Spring”, a dramatic increase of gunshot injuries was reported. It reached an epidemic proportion in the last three years. These injuries are caused by civil violence, police brutality and armed robberies.

Objective : Most of these injuries, including the maxillo-facial ones, are being treated initially in non-hospital conditions and non-sterile environment due to heavy fire, blocked roads and hospitals full to bursting. A pilot study examines the treatment quality, efficiency, and prognosis managed in field medical units.

Methods : In this study, treatment plans of 98 patients with facial gunshots who had been treated in field medical units during clashes were compared with other patients who got similar treatment in hospital sterile conditions.

Result : Hospital treatment of gunshot injuries to the face and neck have been proven to be safer since patients who have received treatment in the field medical units had worse prognosis, delayed healing process, badly healed scars and 5% mortality.

Conclusion/recommendations : The management of facial gunshot injuries should be planned, carried out, and achieved delicately. It takes several stages and procedures to achieve the targeted treatment plan, Bone fixation and wound closure should be carried at the earliest. Infection control is extremely important in the success of the treatment.