Natech (natural hazard-triggering technological) accidents are cascading events arising from the interaction between natural hazards and industrial installations, which pose unique challenges to risk management and emergency preparedness. These scenarios occur when natural events (including those of severe magnitude and low-intensity ones) impact industrial facilities, causing asset damage and triggering hazardous material releases. The occurrence of severe Natech accidents in the past has emphasized the need for comprehensive risk assessment methodologies and effective mitigation strategies. A critical component of Natech risk assessment is the evaluation of safety barriers, both technical (active and passive barriers) and procedural (e.g., emergency response). Indeed, the performance of safety barriers and safety systems may be compromised by the action of natural hazards, increasing the likelihood of technological scenarios. The degradation of safety barriers not only amplifies the risk but also increases the probability of domino effects, further amplifying the consequences of such accidents. This contribution presents methodologies available for Natech risk assessment, including quantitative approaches focusing on the quantitative assessment of safety barrier performance and domino effects in Natech scenarios, thus providing comprehensive and holistic risk figures for the management of Natech risk.