There are a few large studies of the morbidity and mortality of electroconvulsive therapy (ECT). To add data to this literature, we performed a retrospective review of all the patients who underwent ECT at our institution between January 1, 1988, through December 31, 2001. We identified 2,279 patients who were given 17,394 ECT treatments during their first series. The median number of treatments received per patient was 7. Twenty-one patients (0.92%) experienced a complication at some time during their first series of ECT treatments. Cardiac complications, mostly arrhythmias, constituted the majority. However, none of the complications caused permanent injury, and none of the patients died during or immediately after ECT. There were 18 deaths within 30 days of the final treatment, none related to ECT. These data are concordant with those of other published large series, and we conclude that ECT is an extremely safe procedure.