Background Gunshot injuries are considered a burden as well as one of the intricate emergencies in civilian medical practice. In this study, we aim to determine the pattern of presentation and management outcome in a general hospital in a sub-Saharan country.Methods This is a retrospective, descriptive, hospital-based study conducted between January 2015- December 2019 in a general teaching hospital, to review the clinical presentation and management outcome of gunshot injuries. All patients’ records were reviewed during the study period.Results One hundred fifty-seven patients were included in the study, with male predominant 83%. 40% are between 19-30 years of age, with patients under 18 years of age comprising 17% of the population. The common cause of gunshot injuries was personal enmity in 49%. The anatomical sites most affected by gunshot were the lower limb (41.4%) and upper limb (22.9%), and the least impacted site is the perineum (1.9%). The most common diagnoses among the patients in this study were limb fractures (49.7%) and soft tissue injuries (28.7%). Specific treatment in this study is wound debridement, which was done for 91 (58.0 %) patients. Bone fixation, laparotomy, and chest tube insertion were done for the rest of the patients. More than 120 (75%) of patients were treated and discharge in a good condition and 27 (17.2%). The in-hospital mortality rate in this study group was 3.2 %.Conclusion Most of the patients in this study were young males. Upper and lower limb fractures are the most common presentations. Wound debridement, bone fixation, and laparotomy are the most common treatments with significant success rates, despite prolonged hospital stay.