Penetrating craniocerebral injuries (PCIs) are the most fatal injuries of the head that usually have a poor outcome. From the parenchymal destructions to ventricular lacerations, a wide variety of damages occurs during the injury. Surgical treatment is still the mainstay of the management in these patients. Twenty-two consecutive patients with supratentorial PCIs were retrospectively evaluated. Conflicts were the main causes of such injuries followed by suicide attempts and accidental gunfires. Shrapnel and bullet were the most wounding agents. All of the patients underwent surgical treatment following clinical and radiological evaluations. Nine of them were died and 7 were rehabilitated because of severe neurological deficits.