The present review of about 250 relevant publications should give a survey of the current state of electroconvulsive therapy (ECT), which is one of the oldest somatic treatments in psychiatry. It deals with the history of convulsive therapy, comparing studies, biological foundations of ECT, indications, contra-indications and risks, effects on various organs, drug interactions, effects of the electrode-placement and stimulus-waveforms, as well as the application of ECT. The final part can be seen as a reference for practical application of (unilateral non-dominant) ECT.