Though a number of reports on the use of electroconvulsive therapy (ECT) has been published from the Central-Eastern European region over the past two decades, a systematic review of this literature has not been published. Thus the aim of this paper was to review recent trends in ECT practice in Central-Eastern Europe. Systematic literature search was undertaken using the Medline, PSYCHINFO and EMBASE databases covering the period between January 2000 and December 2013. Relevant publications were found from the following countries: Bulgaria, Croatia, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Serbia, Slovakia, Ukraine, but none from Albania and Moldova. ECT practice in the region shows a heterogeneous picture in terms of utilization rate, main indications, and the technical parameters of application. On one end of the spectrum is Slovakia where the majority of psychiatric facilities offer ECT, on the other end is Slovenia, where ECT is banned. In about half of the countries schizophrenia is the main indication for ECT. In Ukraine, unmodified ECT is still in use. Clinical training is generally lacking in the region and only 3 countries have a national ECT protocol. Possible ways of improving ECT practice in the region are briefly discussed.