Electricity generally kills you in one of two ways.
At low current levels, electricity can interfere with the heart’s rhythm. Your heart has a bit of a funny design in the way its pacing system works, and if you get its rhythm screwed up, the heart just kinda sits there and shakes chaotically. This is called fibrillation, and since the heart isn’t really pumping blood at this point, you pass out fairly quickly and die a short time later due to the lack of blood flow (and lack of oxygen) to your brain.
The funny thing about the heart’s design is that this fibrillation state is stable, meaning that if you get it into this state, the heart will happily stay in fibrillation forever (or at least until you die). Better hope that someone is standing next to you with a portable defibrillator. Otherwise there’s a good chance you’re toast. And even with a defibrillator, nothing is guaranteed.
It takes a surprisingly small amount of current to throw the heart into fibrillation. Most safety standards are built around 5 mA as being the “safe” amount of current that can pass through the heart, though obviously there is a bit of guesswork involved here and we haven’t exactly done a huge amount of human testing to verify this number. As the current increases above 5 mA, the chance of fibrillation and death increases, and once you get around 100 mA the chances of stopping the heart are pretty good.
To put it in perspective, most household circuits will trip the breaker at either 15 or 20 amps, which is 15,000 and 20,000 mA respectively.
The thing about this type of death though is that it is very hit and miss. The heart is significantly more susceptible to getting thrown out of rhythm at certain phases of its heartbeat than others, so there is a huge amount of randomness here. Most people who get shocked by 120 volts don’t die, but the chance of death is there. The current also has to go through your chest cavity, which is easily possible if you are standing on a ladder and trying to touch an appliance cord to wires inside an overhead junction box. All it takes is one hand to touch any of the live bits and the other hand to touch the outside of the junction box.
If you are a stupid kid like I was and grab both prongs of the plug when you plug something in, the path of the current is from your finger to your thumb and doesn’t go through your chest.
Just keep in mind that anything metal that touches the ground (water pipes, aluminum siding, sink faucets, etc) is basically grabbing onto the neutral and ground connections, electrically speaking. It’s very easy to accidentally create a circuit where the path of the current goes through you and through your chest.
As the current level continues to rise, the chance of death surprisingly starts to decrease. This is because if you get enough current going through the heart, instead of going into fibrillation, the heart muscles all just clamp. This is still bad, since the heart isn’t pumping blood, so if no one is around to remove the source of the current, you’re toast. But once the source of current is removed, under these circumstances the heart usually just starts beating again. At 120 volts you usually don’t get enough current for this type of thing, but depending on circumstances it can happen.
Increase the current further though and you get into the second way that electricity kills you. It literally cooks you to death. Current flowing through anything other than a superconductor will make heat. If you put a nail in either end of a hot dog and connect the two wires of an electrical cord to those nails (one to each nail), and then plug the cord in, you’ll cook the hot dog in a surprisingly short amount of time. This is one of those Mr. Wizard type science experiments that they used to show on TV, though it is extremely dangerous to do this in real life since the nails are basically exposed electrical contacts.
This type of shock isn’t so hit and miss and with enough current, it’s pretty much guaranteed to kill you. This is how the electric chair kills people, and as long as the chair is functioning properly (an important qualifier), it is extremely reliable in killing someone. The level of current and the duration matter here. A longer duration equals more heat generated equals more cooking, and hence a greater chance of death.
While getting cooked to death is a pretty reliable way of killing someone, that’s not how people usually die from 120 volt shocks. Fibrillation is what gets most folks, or something physical like falling off of a ladder and hitting your head.