Since its introduction, electroconvulsive therapy is a treatment used in mood disorders, especially in the depressive phases of bipolar disorder. The advance of this technique has made it a useful and current option both in the treatment of acute phases as in the prevention of recurrences. The objective of this revision is to collect available data about the use of electroconvulsive therapy in bipolar depression. Its indications, effectiveness, prediction and patterns of response are included in this work, together with its complications, adverse events and drug interactions. Differences in response between bipolar and unipolar depression are also discussed.