The efficacy and safety of Electroconvulsive therapy (ECT) in adults is well-supported by a history of robust research and clinical experience. There is less information regarding the application of this therapeutic modality for the treatment of severe psychiatric disorders in children and adolescents. However, available data suggest that ECT is a safe and effective intervention for severe mood disorders, psychosis, and catatonia in this population. The American Academy of Child and Adolescent Psychiatry (AACAP) and American Psychiatric Association (APA) have published professional guidelines for the practice of ECT in this age group. Unfortunately, child and adolescent psychiatrists typically have little training or knowledge in the practice of ECT. The authors review the historical use and current practice of this modality in minors. Further research and clinical experience is imperative in this area of child and adolescent psychiatric therapeutics.