Electroconvulsive therapy (ect) is an uncommon treatment in children and adolescents. This could partially be explained by the fact that a large proportion of the (child and adolescent) psychiatrists have little knowledge on ect in youths. We describe a case of a 12-year-old boy with a severe depression refractory to pharmacotherapy and psychotherapy, in which ect treatment was successful, including six years follow-up. Additionally, this report represents the state of the art concerning the efficacy and safety of ect in youths.