Although electroconvulsive therapy (ECT) is being performed in many hospitals in Japan, there is little information on its present practice. We surveyed ECT practice to improve the practice of ECT in Japan. A mail questionnaire survey of ECT practice was conducted between 1997 and 1999 in Japan. Of 84 university hospitals and 37 national hospitals, 86 respondents (71%) were obtained. ECT was performed in 56 hospitals (65%). Details of ECT practice were further surveyed in 46 hospitals. The number of patients per year receiving ECT varied according to hospitals from 0.5 to 120. Unmodified ECT was still used in two thirds of the hospitals. Modified ECT was mainly performed in an operating room. Unilateral ECT was seldom used. Japan is an under-developed country for ECT and the practice of ECT must be improved.