This study aimed to quantify rates of nerve involvement, management strategies, and return of functional impairment in patients with civilian extremity gunshot wounds. We performed a retrospective review of 34 patients presenting with extremity gunshot wounds with nerve injury to our level 1 trauma center between January 2019 and October 2021. The incidence of nerve involvement and functional deficits after extremity GSW and rate of return of function after operative or non-operative management were reported. Nerve involvement was found in 34 (34 %) patients in the cohort with 23 (68 %) involving the upper extremities and 11 (32 %) involving lower extremities. Among patients with nerve injuries, 81 % had concomitant fractures. 59 % of patients reporting sensory only, 34 % sensory and motor, and 6 % motor only deficits. 31 % of nerve injuries underwent a surgical procedure targeting their nerve injury with the remaining 69 % managed nonoperatively. Complete resolution of nerve functional deficits in the 29 patients with at least 90 days of follow-up or full return of function was reported in 22 % and 32 % of patients who were treated operatively and nonoperatively, respectively (p = 0.62). Nerve injuries were found in approximately one-third of the extremity gunshot wounds at our trauma center. These injuries carried poor prognosis with low recovery rate with either operative or non-non operative treatment.