OBJECTIVES: The aim of this study was to show distinctions of self-inflicted craniocerebral injuries made with a captive bolt pistol. Furthermore, the goal was to analyse entry point of wound, presence of loose bone fragments in intracranial space, intracranial haematoma and intraventricular hemorrhage as well as the connection of the entry point of wound, intracranial haematoma, intraventricular hemorrhage and Glasgow coma scale with the treatment outcome. The presence of neurological deficits in surviving patients was evaluated before discharge. Finally, the relationship between the entry point of wound, intracranial haematoma, intraventricular hemorrhage and Glasgow coma scale was compared. STUDY DESIGN: The study is structured as a twenty two-year cross-sectional study. METHODS AND PARTICIPANTS: The subjects were patients treated at the Department of Neurosurgery, University Hospital Centre Osijek from January 1st 1995 till December 31st 2016 for clinically and diagnostically confirmed head trauma self-inflicted with a captive bolt pistol. RESULTS: During the twenty two-year period, 14 patients were treated due to self-inflicted head trauma with a captive bolt pistol. All the patients were male. 6 patients survived the trauma. 4 of surviving patients didn't show signs of neurological deficits, 1 developed a minor neurological deficit (he needed support while moving) and 1 developed a severe neurological deficit (left sided hemiparesis). 5 patients with frontal region entry point survived the trauma with 1 of them developing a minor neurological deficit. 1 of 7 patients with temporal region entry point survived the trauma and developed severe neurological deficit. Single patient with parietal region entry point didn't survive. 2 patients that didn't develop intracerebral haematoma nor intraventricular haemorrhage survived without developing neurological deficit. Single patient that developed only intracerebral haematoma survived with neurological deficit. 3 of 11 patients that developed intracerebral haematoma as well as intraventricular hemorrhage survived with 1 of them developing a severe neurological deficit. 6 patients whose GCS score was 13 or higher survived, while 7 patients with GCS score of 12 or lower died. CONCLUSION: This study indicates that GCS score as well as the presence of intracerebral haematoma and intraventricular haemorrhage can serve as prognostic factors regarding head injuries self-inflicted by captive bolt pistol.