Gunshot wounds (GSWs) to any part of the body can leave a trail of insidious complications. When the spinal cord is the injured organ, these sequelae can be debilitating to the patient and often exhaust all known therapeutic approaches available to the providers. The management of pain associated with GSWs to the spine is often a clinical challenge and there is often a question as to whether or not surgical intervention can help with pain relief in these cases. Here, we present a 45-year-old woman who experienced delayed radicular pain following a GSW to the spine with a retained bullet at the level of the lumbosacral canal. After an unsuccessful comprehensive multimodal analgesia, the patient underwent surgical removal of the bullet, which did not successfully provide a substantial lasting analgesic effect. This case demonstrates the potential for surgical failure and supports the general recommendation of more conservative management in this population.