There are over 25 active insurgencies in progress worldwide today. Terrorism is often part of these actions. But terrorism is also found worldwide in areas where no active insurgency exists. There has been a sharp rise in terrorist activities in the last five years, and there will continue to be an increase in such activities in the future.

Bombs, in various assortments, are the favorite weapons of terrorists. When guns are utilized, they are often of the military type and produce subsequent high velocity missile injuries which have entirely different characteristics than the normal type of handgun injury encountered in the civilian practice of medicine. The type of wounds produced by bombings include blast injuries, burns, multiple fragment injuries, blunt trauma, and major mutilation to include amputation. High velocity missile injuries produced by the use of various military rifles and submachine guns require treatment by a surgeon knowledgeable in the care of such wounds. Surgical lessons learned by military surgeons dating back to the time of Napoleon's surgeon Larrey are discussed in some detail in the article. Special considerations attending to medical care associated with terrorist activities are highlighted. Such consequences include multi-system trauma to an individual, trauma to large numbers of individuals at one time, massive trauma to individuals, and the difficulty in treating and evacuating victims who are trapped in rubble.