South Africa has a high level of violence, as more people are killed by gunfire each year than in motor vehicle accidents, and the numbers are increasing. Regrettably, children are affected most by this epidemic. During 1997, a total of 142 children aged less than 14 years died from gunshot injuries while many more were injured. Here we present the case of an 11-year-old male street child who sustained a gunshot to the face, and illustrate the magnitude of the problem. The escalating epidemic of firearm-related injuries and deaths among children and adolescents in Cape Town, like in many other parts of the world, calls for concern. Further research is needed to understand firearm-related injuries among children and adolescents in South Africa, and to develop policies and programmes for effective prevention of situations such as this.