This paper details the experiences of a military surgical team in Belfast from 1972 to early 1974. The overall picture of the problem is given and the current management of 'war' injuries discussed. Up to February 1974 over 1000 servicemen have been injured in Northern Ireland as a result of the vivil disturbance. Over 200 have died. Because of the close proximity of the hospital to many battle areas, casualties may arrive with massive injuries, requiring major resuscitation. Limb wounds have predominated. There is no short cut to adequate wound debridement, especially in the surgery of high-velocity missile injury. Missile wounds of the large bowel require a colostomy. Formal thoracotomy is increasingly used for the through-and-through gunshot wounds of the chest. Controlled ventilation is playing an increasingly important role in the management of some missile wounds of the head. Mine and bomb explosions frequently cause multiple injuries, requiring extensive surgery on any one patient.