Introduction Violence and death resulting from firearms has been a ubiquitous problem for Latin American nations. Ecuador has dealt with this problem and its repercussions to varying degrees in the last 20 years. In order to tackle this violence, a different point of view may be needed. We aim to provide a Public Health perspective to aid in the development of good policy and to monitor the result of interventions by defining the role of firearm violence on premature mortality and estimating its toll on the community. Methods Certificates for all recorded deaths attributed to firearms in the period between 1998 and 2018 were obtained from the Ecuadorian data banks. These records were organized in age groups and according to ICD-10 categories. Years of life lost were calculated for all groups and intentionality. In order to establish a comparison, all causes of death during the last five years were ranked by the total number YLL calculated. During the studied years, a total of 27.146 fatalities were recorded; 25.355 (93,40%) were males, and 1.791 (6,6%) females. The average death rate for the 21 years is 9,46 per 100.000. A total of 670,384 years lost were computed, males lost 624,954 years, and females 45,430, the most enormous amount of YLL was found among persons between 20-40 years of age. For males during, the last five years of the series, deaths from firearm injuries are, consistently among the 5 leading causes of premature mortality. Conclusions While being preventable, firearm violence is a leading cause of premature mortality in Ecuador, heavily affecting the younger population and special young males. For this demographic, firearms generate more loss of life than any other cause excluding, Vehicular accidents and Suicide. It is true even when the overall rates of firearm deaths are lower now than in the previous decade. There is a pressing need for firearms to be considered from a Public Health perspective, and for policy and intervention to be guided by data and studies like it can be used to monitor and aid policymakers.open석
