Gunshot injuries are a major problem worldwide from the human, medical, and economic perspectives. The number and characteristics of gunshot fatalities have been observed to vary significantly between countries. This study analyzes fatal gunshot wounds in the region of Uusimaa, Southern Finland, between 1995 and 2001. Gunshot wounds were typically found in suicides committed by men aged between 20 and 60 years. In most cases, a handgun was used. Mental disorders were present in the history of almost one quarter of the victims. Alcohol was identified in postmortem toxicology in half of the cases, but drugs of abuse were relatively uncommon. The autopsy rate in Finland is among the highest of the European Union countries, and a medicolegal investigation is performed in virtually all fatal gunshot incidents. This study is therefore representative of forensic investigations of gunshot fatalities in Finland overall.