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Nepal has a very large topographical variation; this elevation change has a major influence on lightning occurrence and human casualties. The Himalayan peaks cover the northern part of Nepal with low population density, the middle is covered by hills with intermediate density, and the southern plain with the greatest density. This study will leverage lightning detection by Vaisala’s Global Lightning Dataset GLD360 network with a recent detailed compilation of lightning casualties from 2011 through 2020. Over one million lightning strokes per year were detected from 2016 through 2020. Stroke density is least over high elevations to the north, moderate in hilly regions, and very frequent over the south. The thunderstorm season begins in March and ceases by August after the annual monsoon cycle. Of all the natural disasters, lightning has been recorded to be the second highest killer after earthquakes. The Ministry of Home Affairs reports an average of 103 lightning deaths per year. The fatality rate of 3.8 deaths million−1 year−1 is highest among the South Asian countries. Fatalities over high mountains are rare, with most casualties over the center of Nepal. Lightning Fatality Risk is not a good indicator of the fatalities that occur in a district.