Objective: To review neurologic sequelae of lightning strikes, to consider prevention and management, and to discuss current knowledge about the mechanism of lightning damage to tissues. Results: Most lightning-related neurologic damage involves the CNS as opposed to the peripheral nervous system. The neurologic syndromes can be divided into the following four groups: immediate and transient, immediate and prolonged or permanent, delayed, and traumatic lesions secondary to falls and blast effects. Neurobehavioral complications are frequent and resemble the symptoms of patients with traumatic brain injury. Treatment of CNS lesions, such as posthypoxic encephalopathy and intracranial hemorrhages, is similar to that applied to patients with traumatic brain injury. Many patients with lightning strike are healthy, young individuals engaged in outdoor recreational activities. The mechanism of tissue injury is discussed. Conclusion: Lightning is an awesome force that is responsible for devastating neurologic conditions.