A case of a 32-year-old male soldier with a history of pain in left wrist 15 months after the patient received pellet injuries in a grenade attack firearm injury is presented. Radiography revealed avascular necrosis (AVN) of the left lunate (Kienbock’s disease) with a small metallic pellet embedded in the lunate. We postulate that the AVN may be either due to disruption of the vasculature, mechanical overload or metallosis. To our knowledge, this is the first time a firearm injury resulting in a retained pellet in the lunate has been implicated in Kienbock’s disease.