Isolated gunshot wounds of the orbital contents are relatively rare, and therefore their management deserves updating in terms of current practices. Two cases of isolated gunshot wounds to the orbital contents are presented, and the diagnosis, management, and prognosis are reviewed. In general, in the absence of light perception, enucleation within a planned timetable is the treatment of choice to prevent sympathetic ophthalmia from destroying sight in the uninjured eye. If light perception is present, every attempt should be made to preserve the injured eye. Enucleation of a blind injured eye is the treatment of choice because it is a more complete eradication of the potential for sympathetic ophthalmia. In selected cases, evisceration can be successfully substituted.