The cost of firearm injuries in the United States in 1990 was an estimated $20.4 billion. This includes $1.4 billion for direct expenditures for health care and related goods, $1.6 billion in lost productivity resulting from injury-related illness and disability, and $17.4 billion in lost productivity from premature death. While these are the best available national estimates, it is likely that they underestimate the economic impact of firearm injuries because they are based on relatively old data and on many assumptions necessitated by data gaps. The need for better data and improved estimates, and their policy relevance, are discussed.