About 90% of people who are struck by lightning survive. That number, from the CDC, is higher than most people expect. But surviving doesn’t necessarily mean walking away unharmed. Up to 70% of survivors experience significant long-term health problems, and the type of strike, the body’s immediate response, and how quickly bystanders act all influence the outcome.
Why Most Strikes Are Survivable
Lightning delivers roughly 30 million volts in a fraction of a millisecond. That sounds unsurvivable, but the extreme brevity of the exposure is what saves most people. Unlike prolonged contact with household electrical current, a lightning strike passes over and through the body almost instantaneously. Much of the current actually travels along the outside of the skin rather than penetrating deep into organs, a phenomenon called “flashover.” This is why clothing can be shredded or ignited while the person underneath, though seriously injured, is still alive.
The primary cause of death is cardiac arrest. The massive electrical discharge can throw the heart into a chaotic rhythm or stop it entirely. In many cases, though, the heart’s own pacemaker cells are able to restart a normal rhythm on their own within seconds. The bigger danger comes next: even after the heart restarts, the muscles that control breathing may remain paralyzed. Without oxygen, the heart stops a second time. This is why CPR from a bystander is so critical in the minutes after a strike.
The Five Ways Lightning Hits People
Not all lightning injuries involve a bolt hitting someone directly. In fact, direct strikes are the least common type. Ground current, where the energy spreads outward along the surface after hitting a nearby object, causes the most lightning deaths and injuries because it affects a much wider area. Anyone standing outdoors near a strike point is a potential victim.
A side flash happens when lightning hits a tall object, like a tree, and a portion of the current jumps to a person standing within a foot or two. This is why sheltering under a tree during a storm is one of the most dangerous things you can do. Conduction occurs when lightning travels through metal wires, plumbing, or other connected surfaces, and it’s the main cause of indoor lightning injuries. The fifth type, called a streamer, involves upward electrical discharges from the ground that connect with a developing lightning channel. Any of these five types can be fatal.
What Happens to the Body
Lightning can cause burns, but they’re often surprisingly superficial. Four types of skin injuries are common: linear burns along moisture-rich areas of the body, small punctate burns that look like cigarette marks, thermal burns from ignited clothing, and the distinctive fern-like patterns known as Lichtenberg figures. These branching, tree-shaped marks appear within an hour and typically fade within 48 hours. They aren’t true burns but rather patterns left by electrical discharge along the skin’s surface, named after the 18th-century physicist Georg Christoph Lichtenberg.
A more alarming immediate effect is keraunoparalysis, a temporary paralysis of one or more limbs. The affected limbs become pale or mottled, pulseless, and completely immobile. This usually resolves within a few hours without treatment, though some survivors report lasting weakness. The paralysis can be so complete that even an otherwise healthy person is unable to move or escape danger in the aftermath of a strike.
Long-term Effects Survivors Face
The 90% survival figure can be misleading if you read it as “90% of people are fine.” Many survivors deal with chronic problems for months or years, particularly involving the nervous system and the heart. The brain and spinal cord absorb significant energy during a strike, and the resulting damage shows up in ways that aren’t always visible.
Cognitive problems are among the most common lasting effects. Survivors frequently report trouble with attention, concentration, memory, and learning new information. Fine motor skills can deteriorate, making it difficult to write or handle small objects. One documented case showed a survivor developing pronounced hand tremors, slurred speech, memory difficulties, and episodes of feeling disconnected from reality within three months of the strike, with abnormalities still present at five months.
Psychiatric effects are widespread too. Post-traumatic stress disorder, depression, panic attacks, personality changes, emotional instability, sleep disruption, and difficulty handling stressful situations are all well-documented in lightning survivors. These neuropsychiatric effects can be as disabling as the physical injuries, and some represent permanent changes rather than temporary aftereffects.
Who Gets Struck Most Often
Lightning fatalities in the United States have dropped dramatically over the decades, largely because fewer people work outdoors and more people have access to substantial shelter. In 2024, 13 people died from lightning in the U.S. The 10-year range runs from a low of 10 deaths in 2016 to a high of 40 in 2015. Men are struck far more often than women, primarily because of greater time spent in outdoor activities like fishing, farming, sports, and construction.
You Can Still Be Struck Indoors
Lightning enters buildings three ways: a direct hit to the structure, through wires or pipes that extend outside, or through the ground itself. Once inside, the current can travel through electrical wiring, plumbing, phone lines, and even metal reinforcement in concrete. This means you’re at risk if you’re using a corded phone, touching a plugged-in appliance, taking a shower, washing dishes, or leaning against a concrete wall during a storm. Small structures without plumbing or electricity, like picnic shelters and dugouts, offer no real protection.
What to Do If Someone Is Struck
People who have been hit by lightning do not carry an electrical charge. It is completely safe to touch them. This is one of the most important facts bystanders need to know, because hesitation costs lives. Call 911 immediately, then check whether the person is breathing and has a pulse. If they aren’t breathing, start mouth-to-mouth rescue breaths. If there’s no pulse, begin CPR and continue until emergency responders arrive.
The heart often restarts on its own after a strike, but breathing may not. Providing rescue breaths during this window can prevent the secondary cardiac arrest caused by oxygen deprivation. It’s also unusual for a lightning strike victim to have major broken bones or severe bleeding unless they were thrown or fell from a height, so moving them to a safer location is generally reasonable if lightning is still an active threat.