A study of all firearm fatalities in the Eastern Province of Saudi Arabia during the 10-year period from 1985 to 1994 is presented. The overall number of cases was 71 (0.35 per 100,000 population), of which 48% were homicides, 28% were suicides, and 24% were accidental. Most victims were young male Saudis; most were shot in the chest (41%) or the head (34%). Hand guns were responsible for all suicides, 56% of homicides, and 71% of accidental deaths. The study shows some resemblance between the homicide and suicide groups with regard to the age of victim, type of weapon used, and site of entrance wound. The findings in the present study are comparable to reports from other Middle East countries, but different from those in communities with different cultural and legislative backgrounds. Our findings may support the argument that more strict firearm legislation is helpful in limiting the number of firearm fatalities in the community.