Penetrating trauma results in significant morbidity and mortality. Although firearm and knife wounds are the most commonly considered, other missile‐type injuries can occur. Familiarity with the physics and mechanics of penetrating trauma as well as an understanding of how penetrating trauma affects different areas of the body and special populations will enable EMS clinicians to optimize the care that is provided to these patients, thus improving their long‐term prognosis. EMS physicians play a pivotal role in this by ensuring that the EM clinicians and paramedics in their systems are as up‐to‐date as possible on current management standards and novel therapies.