Gunshot injuries (GSIs) pose a critical public health issue in Nigeria, driving a surge in both morbidity and mortality, especially among young adults. This retrospective cross-sectional study sheds light on the scope and outcomes of GSIs across three regions of Nigeria, South-West, North-Central, and North-West over a six-month span. By analysing data from 240 victims admitted to tertiary hospitals, the study uncovers key insights into demographics, injury patterns, and treatment outcomes. The vast majority of victims were male (91.67%), with an average age of 33.9 years, and the findings pointed to a significant occupational risk among farmers and businesspersons. Lower limb injuries were most frequent (36.67%), while multiple injuries affected 29.17% of patients. A substantial 35% required blood transfusions, often indicating more severe injuries. While the overall survival rate was promising at 78.3%, mortality peaked in the North-West region (11.02%) over six months, likely reflecting heightened violence. Crucial factors influencing survival included age, injury site, and the need for transfusions. These findings call for urgent, region-specific interventions, enhanced trauma care systems, and equitable resource allocation to reduce the toll of GSIs in Nigeria.