A critical prospective analysis was conducted for the missile injuries of the extremities in Basrah University Department of Orthopaedic Surgery at the time of operation Iraqi Freedom (20th of March – 20th of April 2003). The wounds were classified into four grades according to the severity of the injuries. Wound closure was performed primarily in 20 (16%), secondarily in 44 (35.2%) while skin graft was necessary for 36 (28.8%) patients. Although the transportation time was less than two hours, the injuries were severe because of the close proximity of shortening. Collapses of the old houses in Basrah were responsible for the associated closed or open injuries. Primary wound excision was insufficient in 37(27%) patient, this was related to the lack of experience by the junior staff, and was the reason behind the high incidence of wound infection which was recorded in 78 (56.93%) patients. Compound fractures were recorded in 66 (48.17%) patients, soft tissue injuries were noticed in 43 (31.38%), while amputation was the final outcome in 24 (17.5%) patients. The injurious agents were fragments of shell in 74 (54.01%), bullets in 34 (24.81%) while closed injuries were noticed in 12 (8.65%) patients. The fractures were immbolished by external fixation in 24 (9.48%), temporary internal splint in 13 (9.48%), gypsona in 29 (21.16%). The mortality rate was 4.83%. The infection rate and other complications could have been lower if war surgical principles were accepted and performed precisely in the management.