Background: Electroconvulsive therapy (ECT) dates back to the beginning of biologic psychiatry. Particularly, the introduction of general anesthesia and muscle relaxation as well as recent advances in ECT technique greatly reduced the incidence of complications related with ECT and post- interventional adverse cognitive effects. Today, ECT is still the most effective acute antidepressant treatment. In most countries ECT is used for the treatment of severe depression that failed to respond to psychopharmacotherapy and other therapy. Because ECT provides a fast response, it is specially recommended for lifethreatening illness conditions including agitation, stupor, food restriction or high suicide risk. Conclusions: Within the profession up-todate ECT is considered safe, effective and rapid working treatment for the severest forms of mental disorders. On the contrary, ECT is not performed in Slovenia. No professional reason exists that ECT would not be available in Slovenia. By Slovenian Mental Health Act ECT is considered as a special treatment option for mental disorders, but momentarily different barriers limit the availability of ECT to Slovenian patients, particularly to patients in acute illness conditions.