In the repair of burn wound, high-voltage electrical burn wound is still the most complicated and the most difficult one to deal with. According to the clinical experience of author and the literature at home and abroad, this article systematically discusses the early treatment of high-voltage electrical burn wounds, including limbs escharotomy, fasciotomy, and early debridement, and the repair of high-voltage electrical burn wounds in various parts, especially in some special parts, focusing on the repair of the life-threatening parts and site of large vascular injury. At the same time, this article discusses the feasibility and necessity of functional reconstruction. We should make full use of modern repair technology and innovation, interdisciplinary cooperation, so as to reduce disability rate, amputation rate, and mortality of patients with high-voltage electrical burns as far as possible.