Electrical injury is one of the most common public health problems and is often associated with high morbidity and mortality. In patients who survived, a particular concern relates to cardiac injury and the risk of delayed cardiovascular complications. Currently, there is no widely accepted protocol for the management of these patients. As a result, physicians are often uncomfortable dealing with these cases due to the sparse literature on this phenomenon. This review aims to summarize various studies on the effects of electrical injuries on the cardiovascular system and ultimately to improve physicians’ awareness to provide optimal management to this common but relatively unfamiliar situation. Current evidence suggests that patients exposed to electrical injury with unstable vital functions and/or risk factors and/or an abnormal ECG should be admitted to the intensive care unit, while asymptomatic patients with no risk factors and a normal initial ECG need no inpatient cardiac monitoring and may be discharged from hospital. While troponins could be a relevant marker in electrical accidents due to their high specificity for cardiac damages and represent a potentially promising tool in the future to aid decisions.