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The aim of the study was to describe the rate of use and demographic distribution of electroconvulsive therapy (ECT) in Norway in 2004, as well as the attitudes among Norwegian psychiatrists about ECT.A 42-item questionnaire on the practice of ECT was sent to 125 Norwegian psychiatric hospitals, district psychiatric centers, and child and adolescent psychiatric units in 2004.A total of 67 (54%) psychiatric units responded, including 26 (67%) of 39 psychiatric hospitals, 32 (46%) of 69 district psychiatric centers, and 9 (53%) of 17 child and adolescent units. There were 672 patients who received ECT during 2004, which gives a yearly incidence of 2.4 of 10,000 inhabitants. A total of 5.3% of all inpatients received ECT.The rate of ECT use varied from 1.83 to 3.44 per 10,000 inhabitants per year between the different health regions.Of the 672 patients, 394 reported their sex (59%), of which 135 were men and 259 were women (male-female ratio, 1:2). The most common diagnosis treated with ECT was depression, followed by bipolar disorder and schizoaffective disorder.The responders expressed generally positive attitudes toward ECT. Almost all considered ECT important, that hospitals should offer ECT, and that there are solid indications for such treatment. Most of the responders expressed concern about the underuse of ECT.Electroconvulsive therapy is widely available in Norway but its use is unevenly distributed between health regions. The attitudes toward ECT are generally positive among psychiatrists.