Purpose : This study discusses the firearm injuries in the maxillofacial region, protocol for primary care and management, the complications encountered and the outcome of the patients in Asyut University Hospital in upper Egypt.

Patients and methods : 47 cases were received the primary care and treatment in Assiut University Hospital – were admitted and treated, the results were recorded and analysed.

Results : Mandible (area III) was the common site of injury, the CNS and ocular injury have the same frequency of association. The most common complications were deformed commissure and scars. Cases with bone loss of the mandible leads to mal-occlusion and associated with mandibular and cervical branch facial nerve injury.

Conclusion : Recommendation of simple approach, post operative safe air way and avoidance of sophisticated technique in the stage of primary care and treatment.