A retrospective study from July 2002 to June 2012 was carried out to evaluate firearm injuries and associated factors. Among the victims included non fatal cases admitted and treated in MKCG Medical College, Hospital, Berhampur and fatal firearm cases referred for autopsy to the Forensic Medicine & Toxicology Department, MKCG Medical College, Berhampur.The total number of cases was 179 out of which 73 were fatal and 106 cases were non fatal.The total incidence in Ganjam district has doubled from 0.45/100,000 in 2008 to 0.9/100,000 in 2011-12. Most of the victims were middle-aged males (51 cases; 70%). The male to female ratio was 24:1. Sixty instances (82%) of firearm deaths occurred in the rural areas, with majority of them happening at night (39cases; 53%). Most cases were homicides (69 cases; 95%). Three cases (4.0%) were suicides and one case (1.0%) was accidental. The most common site of entry was the chest (26 cases; 36.0%), the head (20 cases; 27.0%).Lungs is the most common organs affected in twenty nine cases(40%).Handguns like pistols and revolvers were responsible for 42 cases (58.0%) and Shotguns in 17 cases (23.0%) of firearm injuries.These results support the argument that rigorous pursuit of campaign firearms without a license and arresting them is useful in reducing the number of firearm deaths.