This study reports findings from the pilot phase of the Houston hospital-based violence intervention program (HVIP). Between January and March 2025, 15 gunshot wound patients aged 16–35 years were enrolled and randomized to receive either intensive three-month case management or usual care. Participants had high socioeconomic vulnerability, and moderate levels of PTSD symptoms and attitudes toward guns and violence. The pilot study achieved an 85.7% follow-up rate, demonstrating the feasibility of enrolling and retaining this population. Findings lay the groundwork for a full randomized controlled trial to evaluate the effectiveness of the HVIP in reducing reinjury and improving health outcomes.