In the context of global climate change, lightning disasters have emerged as a serious environmental factor that restricts the sustainable development of megacities. This paper provides a review of the research on the impact of urbanization on thunderstorm processes and lightning activity, exploring various aspects, such as aerosols, urban thermal effects, urban dynamic effects, and building morphology. Despite numerous significant achievements in the study of the impact of air pollutants on lightning activity, there is no consensus on whether aerosols serve to enhance or inhibit lightning activity. The temperature difference between the urban underlying surface and the natural underlying surface could sustain and promote the occurrence and development of convective systems, thus enhancing lightning activity. In terms of urban dynamics, the barrier effect has led to the maximum center of lightning appearing at the edge of a built-up area, which might be associated with factors, such as urban heat island (UHI) intensity, wind speed, synoptic background, and city size. Additionally, the size of a city and the height of the buildings was also an influencing factor on lightning activity. In summary, scholars have made progress in understanding the characteristics and drivers of urban lightning activity in recent years, but there are still some urgent problems that need to be solved: (1) How to analyze, comprehensively, the spatiotemporal patterns of urban lightning activity under different thunderstorm intensity backgrounds? (2) How to conduct analysis to investigate the influence of alterations in the boundary layer structure, water–heat energy balance, and water vapor circulation processes on urban lightning activity in the context of urbanization? (3) How to couple numerical models of different scales to enhance the understanding of the impact of complex underlying surfaces on urban lightning activity? Future studies could investigate the relationship between urbanization and thunderstorm/lightning activity using a combination of observational data, numerical modeling, and laboratory experiments, which holds promise for providing valuable theoretical insights and technical support to enhance the prediction, nowcasting, early warning, and risk assessment of thunderstorms and lightning in urban areas.