Stabbing, mechanical asphyxia, blunt head injury and shooting are the most common methods of homicides, with firearm homicides on the increase throughout the world. This study was a retrospective study carried out by the Department of Forensic Medicine, University of Kelaniya, Sri Lanka over a 1 year period on firearm homicides examined at two principal forensic institutions in the western province (Office of the Judicial Medical Officer Colombo and Ragama) of Sri Lanka. During the period of the study (June 2005 to July 2006) 3100 medicolegal autopsies were carried out at these two institutions with 265 representing alleged homicides. Eighty-three cases (31%) were identified as homicides due to fatal firearm injuries. The majority of the victims (N = 76) were young adult males (aged 18-40 years). Almost half of the firearm homicides (47%; N = 39) were associated with previous enmity, while 33% (N = 27) were due to ethnic rebel killings in the North and East. Daylight hours (6.00 a.m. to 6.00 p.m.) were preferred by rebels, while there was no relation to the time of day in the other firearm deaths. The weapon of choice was a rifled firearm (98%). While 70% of war-related deaths had one or two fatal shots, either to the head or chest, homicides motivated by personal enmity had multiple wounds, with an average of 5.7 fatal shots per victim. This study demonstrates that firearm homicides in Sri Lanka mainly involve young men, and that when related to armed conflict the fatal injury usually consists of a single shot to the head or chest.