Permanent infirmity is an important medico-legal issue. Objectives: this prospective study aimed to assess the pattern and methods used in diagnosis and follow up of permanent infirmity cases referred to Cairo Department of Forensic Medicine, Ministry of Justice, Egypt, as well as, to compare between the national and international guidelines used to assess permanent infirmity. Methodology: only established permanent infirmity cases were studied as regard the demographic and medico-legal data, physical examination, and investigations done to the victims. Results: the incidence of established permanent infirmity cases during the period of the study was 7.2% (150 cases). Most of cases were males of age group 21-40 years, and manual workers. Most of injuries resulted from blunt trauma due to road traffic accidents. The most common investigation done was x-ray; with the majority of cases revealed fractures and amputations of bones of both extremities. The number of permanent infirmities exceeded that of examined cases as some cases sustained more than one injury. Conclusion: limitation of movements represented the highest percentage of the resulted permanent infirmities followed by amputations. The percentages of some infirmities are equal or near equal, and others showed some differences, meanwhile some infirmities were evaluated in the Florida schedule but not in the Egyptian schedule.