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This paper reviews electrostatic discharge (ESD) investigations on laterally diffused MOS (LDMOS) and drain-extended MOS (DeMOS) devices. The limits of the safe operating area of LDMOS/DeMOS devices and device physics under ESD stress are discussed under various biasing conditions and layout schemes. Specifically, the root cause of early filament formation is highlighted. Differences in filamentary nature among various LDMOS/DeMOS devices are shown. Based on the physical understanding, device optimization guidelines are given. Finally, an outlook on technology scaling is presented.