The focus of the chapter is on the diagnosis and therapy, particularly of moderately and severely injured lightning victims, because apparently lightly injured patients either do not need to be hospitalized or can be discharged after just a few hours of monitoring. For the severely injured, diagnosis, therapy, and prognostic predictions are extremely problematic immediately after the patient is taken over by the rescue service. This is due, on the one hand, to the fact that only extremely few doctors have experience in treating lightning strike victims, and on the other hand, that almost no lightning accident is like any other.