Hailstorms are typically localized events, and very little is known about their effect on crops. The objective of this study was to examine the physiological and vine performance responses to natural hail, registered four weeks after full bloom, of field-grown Thompson seedless (Vitis vinifera L.) grapevines, one of the most important table grape varieties cultivated in Greece and especially in the Corinthian region in northeastern Peloponnese. Leaf gas exchange, vegetative growth, vine balance indices, cane wood reserves, yield components, and fruit chemical composition were recorded from hail-damaged vines and compared with control vines. Visibly, the extent of the hailstorm damage was great enough to injure or remove leaves as well as cause partial stem bruising and partial injury or total cracking of berries. Our results indicated that natural hail did not affect leaf photosynthesis, berry weight, total acidity, and cane wood reserves but significantly reduced the total leaf area, yield, and the total phenolics of berries at harvest. At the same time, hail-damaged vines increased the leaf area of lateral canes and presented a higher total soluble solid (TSS) accumulation, while no effect on the next year’s fertility was registered. The present work is the first attempt to enhance our understanding of the vegetative yield, berry quality, and physiological responses of grapevines to natural hail, which is an extreme and complex natural phenomenon that is likely to increase due to climate change.