This is a case of a 32-year-old man who developed intra- and periarticular heterotopic ossification (HO) after sustaining a low-velocity gunshot wound to the femur treated with intramedullary nailing of the fracture using a retrograde technique. The association between HO after a high-velocity gunshot wounds is well established. In addition, there have been two case reports of intra-articular HO after retrograde intramedullary femoral nailing. However, HO in and around the knee after a low-velocity gunshot wound has not been reported and may be more common than initially thought.