The treatment of ballistic fractures has generally been based on the principles of war surgery, using the external fixator. With organised crime on the rise, ballistic fractures are increasingly encountered in civilian practice, caused by unconventional weapons. We conducted a cross-sectional study between 2015 and 2018 at the SYLVANUS OLYMPIO University Hospital in Lomé, TOGO, on the management of ballistic fractures using internal osteosynthesis. This study although on a sample not large enough but sufficient to draw conclusions after comparison with other studies that have been conducted elsewhere.