Abstract Lightning has killed and injured many people in recent years in the Qinghai–Tibetan Plateau area of China when they were collecting a rare product used for medical applications. The fungus that grows on dead caterpillars at high altitudes in this region demands a high price when sold, so it attracts collectors that unfortunately become at risk from lightning during this process. A total of 12 lightning-related events during 2004–22 resulted in 29 deaths and 53 injuries. All cases occurred at high elevations in rugged terrain with no available lightning-safe structures or vehicles. The fungus collection occurred during the daytime hours in late spring and early summer, which is also when lightning is frequent. Maps of lightning for the cases and information gained from the Chinese-language reports are summarized. It is apparent that this is a unique high-risk, high-reward occupation that is similar in terms of exposure to other situations around the world that result in lightning deaths and injuries. Significance Statement Lightning deaths and injuries often occur when people push the limits of safety due to occupational or recreational demands. Most of these decisions are on short time scales such as while tending agricultural fields, working on roofs, running a competitive race, or walking home from school when a thunderstorm is approaching. In the scenario presented here, groups of people with few income alternatives spend weeks or months in mountainous regions where lightning is common, but safety is elusive. This situation is an unusual version of high lightning risk occurring while pursuing a high reward.