The increase in firearm death rates in the US has been attributed to many factors, including higher gun sales, social isolation during the COVID-19 pandemic, and lack of new federal firearm legislation. Studies suggest that both the risk and lethality of firearm injuries have increased, partly due to larger magazine capacity and growing use of high-caliber weapons. Location of death after traumatic injury informs resource organization for both treatment and prevention. Deaths at the scene of injury serve as a proxy for increasing lethality because those patients do not survive transport to a medical facility; however, locations of firearm deaths remain poorly characterized. In this study, we sought to analyze patterns in location of death from firearm injury in the US between 1999 and 2021.