OBJECTIVE To determine the characteristics of electroconvulsive therapy (ECT) practice in Australia. METHODS From October 1, 2002 to February 29, 2004, a 29-item questionnaire was sent to 136 hospitals in Australia. CONCLUSIONS One hundred thirteen hospitals (83%) completed the questionnaire. Electroconvulsive therapy was available in 90 hospitals. A total of 7469 patients received 58,499 ECTs from 356 psychiatrists, which gives an average course length of 8.5 treatments. Electroconvulsive therapy use as assessed by the crude treated-person rate was 37.85 persons per 100,000 population per annum. Of the number of patients, 63.4% were women. Brief-pulse devices were used in all hospitals. Electroencephalogram monitoring was used routinely in 80 hospitals. Of the total number of ECT treatments, 82.3% were given to patients with major depression, 9.6% to patients with schizophrenia, 4.9% to patients with mania, and 1.7% to patients with catatonia. Patients who received ECT were in an age group older than 65 years (38.4%), followed by 45 to 64 years (28.3%), 25 to 44 years (26.3%), 18 to 24 years (6.9%), and less than 18 years (0.2%). Unmodified ECT was not used in any hospital. One thousand one hundred ninety-six patients received continuation ECT in 83 hospitals, and 1044 received maintenance ECT in 77 hospitals. There was no case of ECT-related death during a survey period. Only 31 hospitals rated their teaching program for medical students as acceptable to excellent, and for psychiatry residents, it was 58.