Background <p>Wartime injuries contribute to the global burden of mortality as a major public health threat. Early access to healthcare improves the quality of life of war-injured patients. The patterns of trauma care and its outcomes in war-injured patients have not been documented in conflict-affected regions of the Democratic Republic of Congo, where political crisis and civil unrest lasted more than two decades. This paper describes the pathway to care, referral patterns and treatment outcomes of war-injured patients treated at the Provincial Hospital of North Kivu (PHNK) during the January 2025 crisis in Goma.</p> Methods <p>This retrospective observational study identified 239 war-injured patients admitted at the PHNK between 25th January and 31st March 2025. The study gathered information on patient demographics (age, sex, marital status, and religion), time interval between trauma occurrence and hospital admission, mode of admission, injury patterns (mechanism, site, and type), first medical aid at the trauma site, severity of injury and outcomes (mortality, length of hospital stay, and postoperative infection). Descriptive analyses performed with Stata 15.0 were summarized as proportions, medians or means and standard deviation.</p> Results <p>Most war-injured patients admitted at the PHNK were male (82.3%), single (52.2%), and aged 18–49 years (76.3%). These patients were self-referred (87.1%), did not benefit from first medical aid at trauma sites (86.7%), and had a time interval ranging from 6 to 24&#xa0;h between trauma occurrence and hospital admission (37.4%). Debridement was performed in 54.4% of cases. Tetanus immunization was administered to 15.9% of war-injured patients, whereas 13% benefited from physiotherapy. Only 7.1% of cases benefited from psychological management. The overall mortality rate was 4.4% (11 patients), with 9 deaths occurring within 48&#xa0;h from admission. The mean length of hospital stay was 14 days, whereas 8% of war-injured patients had a postoperative infection.</p> Conclusion <p>These results show the delays in care, self-referral and mortality in war-injured patients in the context of limited resources and conflict. The results call for feasible interventions within a context of high violence such as that of the Democratic Republic of Congo, aiming at strengthening the health system and enhancing community-level capacities to improve the quality of life of war-wounded individuals in conflict zones. This study also shows that a robust health system can deliver an effective response to acute crises if it is equipped with sufficient technical capacity, well-trained staff, essential medicines, and strong organizational structures.</p>