Low voltage electrical injury is associated with minor or no cutaneous burns and its symptoms rarely appear on initial examination. The purpose of this study was to determine the ability to return to work among patients with low voltage electrical injury. A retrospective hospital chart review was conducted among patients with low voltage electrical injury admitted to the outpatient burn clinic of a rehabilitation hospital between January 1, 2002 and March 21, 2006. Symptoms at follow-up visits and return to work status were compared between patients with electrical contact injuries and those with electrical flash injuries using Student's t-test and chi analysis with a P < 0.05 considered significant. Values are presented as mean +/- SD. Forty patients were treated for low voltage electrical injury, and all injuries occurred at work. There were 34 men (85%) and 6 women (15%) with a mean age of 37.3 +/- 11.2 years and a mean total body surface area burned of 13.0% +/- 17.6%. Most patients had neurological (92.5%), psychological (90.0%), and musculoskeletal (72.5%) symptoms, which were documented on average 303.7 days after injury. Twenty-five (62.5%) patients had electrical contact injury and 15 (37.5%) patients had electrical flash injuries. Patients with electrical contact injuries were younger (34.2 +/- 9.9 years vs 42.4 +/- 11.6 years, P = 0.030), complained of more psychological symptoms (25 vs 11, P = 0.006), more neurological symptoms (25 vs 12, P = 0.020), and more fatigue (10 vs 1, P = 0.022) than patients with electrical flash injuries. Twenty-three patients (57.5%, 14 electrical contact and 9 electrical flash) attempted to return to work on average 107.7 days after injury, but only 13 patients (32.5%, six electrical contact and seven electrical flash) successfully returned to work 59.38 days after injury. Of them 7 (53.8%) return to the same job, 5 (38.5%) returned to a modified job, and 1 (7.7%) to a new job. Low voltage electrical injury can significantly impact a patient's ability to return to work because of the psychological, neurological, and musculoskeletal symptoms, which are observed. Recognition of low voltage injury as a potentially permanent source of symptoms is important and has to date not been well established. More effective preventive measures should be implemented at work to reduce the risk of these injuries.