The best way to handle neurological deficits brought on by spine gunshot wounds has been up for debate. Treatment options have ranged widely, from nonoperative to aggressive surgery. Results, clinical information, and patient characteristics were removed. The list of surgical procedures included “laminectomy, neural canal restoration, open reduction, spinal fusion, or internal fixation of the spine.” The primary outcome measure was the American Spinal Injury Association (ASIA) Impairment Scale. Statistics were used to compare baseline demographics and neurological outcomes between the operative and nonoperative cohorts. There were 961 patients with GSI who had at least a year of follow-up between 1975 and 2015. About 89.7% of patients were male, between the ages of 15 and 29, and Black or African American (55.6%). Total of 73.8% a 1-year, 34.2% of surgical patients (19.7% of all patients), as opposed to 20.6% of nonoperative patients, showed improvement on the ASIA Impairment Scale. At one year following surgery, there was a 2.0 [95% CI: 1.4-2.8] chance that the ASIA Impairment Scale would improve overall. Benefit was noted only for lumbar and thoracic injuries (odds ratio: 1.7; 95% CI: 1.1-3.1), but not for cervical injuries (odds ratio: 2.5; 95% CI: 1.4-4.6). Despite the fact that each patient’s circumstances must be taken into consideration, our review of GSIs revealed a relationship between surgical intervention and a higher likelihood of neurological recovery. Patients with thoracic and lumbar GSIs had a 2.5- and 1.7-fold higher chance of improving on their ASIA Impairment Scale scores 1 year after injury, respectively, if they underwent surgical intervention.