On July 1st on 'Territory Day', the public in the Northern Territory are permitted to purchase and operate consumer fireworks without a licence. Serious permanent injuries from fireworks are well described, leading to their banning in many other jurisdictions. This study describes those seriously injured by fireworks in the Top End of the Northern Territory, with the aim of identifying opportunities for prevention and harm minimization. This is a retrospective audit of all admitted patients with an injury from fireworks at the Royal Darwin Hospital between 2000 and 2015. The variables collected included demographic data and the circumstances around injury (operator versus bystander, alcohol involvement and day of device operation). The consequences such as injuries, operating theatre visits, length of stay and outpatient visits are described. Fifty-five patients (including 17 children) suffered 67 injuries over the study period, resulting in 68 operating theatre visits, 322 hospital days and 380 outpatient appointments. Burns, hand and eye injuries predominate. Females (P = 0.000) and children (P = 0.029) were more likely to be injured as bystanders. Injuries on a day other than Territory Day were more likely to have alcohol involvement (P = 0.01), and occur in the operator (P = 0.017). Consumer firework usage results in a small number of life altering injuries annually. Previous prevention campaigns focusing on device user safety should be expanded to include the safety of bystanders and children and reduce firework usage outside of the Territory Day.