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Background: The peripheral nerve is known to be vulnerable to electrical injury. However, the character and mechanism of electrical injury to the peripheral nerve is not well established in clinical conditions. Methods: We retrospectively reviewed the nerve conduction study (NCS) data of patients who had high voltage electrical injury in their upper extremities. Results: Among 16 extremities studied, nine had abnormal NCS findings. Nine of 12 extremities, whose input/output were distal to wrist, showed abnormal NCS findings. In contrast, all four extremities, whose input/output points were their forearm, had normal NCS findings. In the patients who had abnormal NCS findings, the distal portion experienced more severe damage than the proximal portion. Conclusions: Input/output points are important factors in the electrical injury to the peripheral nerve. Joule heating seems to be a more important mechanism of electrical peripheral nerve injury.