Electroconvulsive therapy (ECT) originated in Italy in the 1930s and regained significance in the 1980s due to its efficacy in cases where psychotropic drugs were insufficient. Today, it’s a safe and effective treatment for major depression, mania, schizophrenia, and catatonia. Public misconceptions about ECT exist, leading to reluctance among patients and physicians. Advancements in technology have minimized cognitive side effects, making ECT less risky than pharmacotherapy, especially during pregnancy. Indications for ECT include suicidal thoughts, treatment-resistant depression, contraindications to drug therapy, non-compliance with treatment, and psychotic symptoms. It’s administered under anesthesia and with muscle relaxants, with electrodes placed bilaterally or unilaterally. Treatment frequency is typically 2-3 times per week, with 4-8 sessions generally sufficient. Drug interactions, especially with psychotropic medications, should be considered. While there are no absolute contraindications, caution is advised in certain medical conditions. ECT is highly effective in depression, particularly in treatment-resistant cases and catatonia, often more so than placebo or antidepressants, making it a valuable treatment option for various mental disorders.