The science of ballistics can be confusing. Specific treatment dogmas regarding ballistic injuries should be examined to ensure that they are supported by scientific data. If determined to be unfounded, these dogmas should be discontinued from the teaching centers and eliminated from clinical practice. Tissue injury by ballistic projectiles is caused by the design and composition of a bullet and the velocity it is traveling when it strikes a target. Velocity or projectile shape alone cannot be the basis for any treatment. Each wound must be evaluated individually, with the determination of care decided by fact and clinical assessment, not rigid treatment protocols.