Background: In Ecuador, the number of patients who have suffered gunshot wounds has increased remarkably, mainly due to the increase of terrorist groups. Clinical Case: 17-year-old male, arriving with pain, coldness, and paleness of the right lower limb after a gunshot wound to the right upper limb and right hemithorax. Exploratory laparotomy was performed after CT angiography revealed the presence of a hyperdense image in the right common iliac artery. In the trans operative study, after arteriotomy, a firearm projectile was identified in the lumen of the artery. Thrombectomy and primary repair were performed. Conclusion: Guidelines for the management of this type of patient are lacking. Treatment options and surgical decision must be made individually according to the site of the gunshot, severity of the injury and clinical status of the patient.