Costa Rica’s public hospitals have treated nearly 10,000 gunshot emergencies since 2020, showing how the rise in armed violence is affecting far more people than homicide statistics alone reveal. Data from the Costa Rican Social Security Fund (CCSS) show that 9,970 firearm-related emergencies were recorded between January 1, 2020, and July 31, 2026.
That is equivalent to one gunshot emergency approximately every 5.8 hours. The pace has continued in 2026. During the first seven months of the year, the public health system handled 810 gunshot emergencies, an average of about 3.8 per day. San José recorded the most cases over the full period, with 2,584, followed by Limón with 1,848 and Puntarenas with 1,410.
Alajuela recorded 1,381 cases, Guanacaste 732, Heredia 669 and Cartago 657. The figures show that the effects of Costa Rica’s security crisis extend well beyond the country’s homicide count. Many shooting victims survive but arrive at hospitals with injuries requiring surgery, extended hospitalization and, in some cases, long-term rehabilitation.
Between 2020 and July 2026, 3,606 firearm-related cases required hospitalization. Another 1,968 follow-up consultations were recorded for treatment including rehabilitation, complex wound care, removal of bullet fragments and care for permanent physical disabilities. During the first seven months of 2026 alone, there were 306 hospitalizations related to gunshot injuries and 244 follow-up consultations. The pressure on hospitals has been building for several years.
Earlier CCSS figures showed that the number of people treated in emergency departments for firearm injuries increased from 835 in 2019 to 1,223 in 2023, an increase of about 46%. Doctors have also reported changes in the severity of the wounds they are treating.
Emergency physicians have described patients arriving with multiple gunshot wounds and extensive damage to bones and internal organs. Some injuries have been associated with high-powered weapons capable of causing significantly more damage than the firearms doctors commonly encountered in previous years.
The problem has been particularly visible in areas such as San José, Limón and Puntarenas, which together account for more than half of the firearm-related emergency cases recorded since 2020. Limón alone accounted for 161 gunshot emergencies during the first seven months of 2026, while San José recorded 228 and Puntarenas 120.
The data also illustrate a part of Costa Rica’s violence problem that is often less visible than the homicide rate. For every person killed in a shooting, others survive with injuries that can require emergency treatment, surgery, lengthy hospital stays and rehabilitation. Those cases place additional demands on operating rooms, hospital beds, specialists and follow-up services within the public health system.
Through July, Costa Rica’s hospitals were treating an average of nearly four gunshot emergencies every day in 2026.
