The development of cataracts, a well-known complication of electrical injury, remains poorly understood. We reviewed 113 patients suffering major electrical injuries and identified seven patients who suffered 13 cataracts, an incidence of 6.2%. Six of the seven patients were injured with high (greater than 1,000-v) voltage current, while one man was injured by a 440-v source. All patients suffered true 'entrance and exit' wounds, but only three such injuries involved the head or neck. Cataracts first presented as decreased visual acuity 1 to 12 months postinjury. Ten of the 13 cataracts progressed to a point where surgery was required, from 3 to 27 months postinjury. Surgical therapy resulted in excellent return of vision in every case, although one patient was lost to followup and developed a late retinal detachment. Electrical cataracts remain a serious potential complication of electrical injury. Awareness by burn team members is essential in providing optimal treatment to victims of electrical injury.