Five thousand, seven hundred and twenty-nine consecutive admissions to the three general hospitals and the mental hospital in St. John's, Newfoundland, Canada, were examined retrospectively for the use of electroconvulsive therapy (ECT). The proportion of patients admitted who received ECT (rate), and the number of treatments per admission were recorded. Rate of ECT, expressed as percentage of patients admitted, was assessed for all hospitals separately and compared on legal status and diagnosis. One thousand, two hundred and thirty-six (21.5%) patients admitted, received ECT with little variation over a three year period. The rate was higher for the general hospitals and for voluntary patients. ECT was used in a very high proportion of patients with diagnoses of depression (50%), mania (20%), schizophrenia (36%), and neurotic disorders (20%). These findings are discussed in the context of the overall trend of a low utilization of ECT elsewhere, and the previous research evidence of limited indications for ECT.