OBJECTIVES: The aim of the study were to describe the practice of electroconvulsive therapy (ECT) at the Institute of Psychiatry (IPUB) of the Federal University of Rio de Janeiro (UFRJ) from 2015 to 2019 and to compare it with previous years at the same institute and with international practices. METHODS: Sociodemographic and epidemiological data, along with information on ECT and anesthetic techniques, were collected from the medical records of all patients who received ECT at IPUB-UFRJ between 2015 and 2019. RESULTS: A total of 238 patients underwent 4110 ECT sessions during the study period. A slight predominance of female patients (55.9%) was observed. Most patients were aged between 21 and 40 years (46.2%). Over half of the patients were outpatients (63.4%), with bipolar affective disorder being the most common diagnosis, accounting for 35.7% of ECT indications. Consent for ECT was obtained from all patients. Most treatments (85.2%) were conducted during the acute phase of illness. The average number of ECT sessions per patient was 5.4. All patients received anesthesia, and no deaths or severe complications related to ECT occurred. Monitoring cognitive effects and discharge criteria were the responsibility of the attending physician. CONCLUSIONS: The practice of ECT at IPUB-UFRJ adhered to both local and international guidelines. There has been a notable shift in the utilization patterns of ECT at the institute compared to previous years. Standardized monitoring of cognitive effects and discharge criteria remains essential.