A national survey revealed significant variations in a number of aspects of evaluation and surgical and nonsurgical treatment of patients with gunshot wounds to the brain. There could be many reasons for this. It would seem that there has probably not been sufficient research done to fully understand all aspects of such injuries. It also may be that different ways of caring for these patients provide equally satisfactory outcomes. Another problem that arises is that even with good information, there is difficulty in changing practice patterns that need to be understood better and made more effective. Based on the author's review and ethical considerations, certain basic and reasonable suggestions are made in this article.