Objective. The world statistics on lightning strike outcomes reveals 6000 to 24000 human deaths annually. The lightning strike regular mortality is 20–30% with two thirds of survivors having serious complications and long lasting consequences. Every third person struck by lightning bears skin damage.Clinical observation. The man, 27 years old, was traumatized after the lightning struck into his forehead area. A contused-lacerated wound of soft tissues was diagnosed. The patient was taken to the local district hospital for primary care. 20 days after receiving the injury, he turned to the Saratov Regional Clinical Center for Combustio- logy, where he underwent autodermoplasty of the defect in the integument of the skull.Discussion. Direct lightning strike is technically a result of the immediate contact of the injured with the atmospheric electricity. It comprises no more than 5% all lightning strike cases. The outcome is often lethal as the electrical discharge received is the highest.Conclusion. Autodermotransplanting is advantageous in the replacement of damaged skin integument, inclu- ding that caused by atmospheric electricity. In such situations adequate first aid treatment, timely transportation, staged medical treatment, specialized stationary treatment, proper surgical treatment, and post-operative care are important.