Electricity and lightning account for a large number of deaths per year worldwide. According to data from the Centers for Disease Control and Prevention (CDC), 100 out of more than 500 fatalities caused by electricity are due to lightning and at least two to three times as many nonfatal injuries are reported every year in the United States. Lightning is the third most common cause of deaths from natural causes. The pathophysiology and management of electrical and lightning injuries are unique. Physicians who may encounter such patients in their practice should be knowledgeable in their management. This article reviews the current knowledge about this topic and details a schema for management.