IntroductionGunshot wound injury is notorious for its variable pattern and projectile-related trauma, particularly in the spine. Generally, irrigation and debridement are accepted as the first-line operative treatments. However, it may not result in better outcomes in most low-energy gunshot wounds of the extremities [1]. Whether to remove the bullet immediately in patients with intact neurological function also remains a dilemma. While retaining the foreign body may lead to late migration and even neurological compromise [2], aggressive management may cause collateral iatrogenic injury [3]. Several studies have demonstrated a minimally invasive technique to remove bullets from the cervical spine [4,5]; however, similar procedures for the lumbar spine have rarely been mentioned. Advancements in navigation-assisted surgery have expanded the indications from thoracolumbar pedicle screws to deformity correction and spine tumor resection over the years [6]. Our aim is to examine the applicability of navigation-assisted surgery for lumbar spinal foreign body removal. In this case report, we successfully performed minimally invasive surgery to completely remove one bullet from the lumbar spine with minimal iatrogenic damage to the surrounding tissues by taking advantage of the accuracy and velocity supported by the navigation system.