I think the Yarygin PYa / MP-443 “Grach” pistol, which was adopted as the Russian army and law enforcement service pistol, must be the ugliest modern pistol. What do you think?
It fires the 9×19 mm 7N21 cartridge which is just a very hot 9mm Parabellum.
Click to expand the photo.
More info about the pistol here.