Treatment of gunshot wounds in the maxillofacial region is complex. Current literature supports immediate treatment. Wounds vary widely. The nature of the injuries must be carefully assessed using the Kanzanjian and Converse’s principles of plastic surgery as guidance, but always adapting to specific needs. Management is dependent upon the type of weapon, the bullet’s characteristics, kinetic energy, place of impact, as well as the patient’s general health status. A case is presented of a gunshot injury to the face with a review of the literature.