To evaluate the safety of a policy of selective nonoperative management in patients with abdominal gunshot wounds, the authors reviewed the records of 1856 patients treated selectively during an 8-year period. Patients who did not have evidence of peritonitis, were hemodynamically stable, and had undergone a reliable clinical examination were observed. Initially, 792 patients (42%) were observed, with 4% developing symptoms requiring delayed laparotomy. Five patients (0.3%) experienced complications potentially related to the delay in laparotomy, all managed successfully. The rate of unnecessary operations was low, with 712 patients treated without an operation; this saved approximately 3500 hospital days and $9.5 million in hospital charges. Thus, selective nonoperative management is a safe method for treating abdominal gunshot wounds in a level I trauma center with an in-house trauma team. It should not be the rule where less attentive coverage is noted.