Electroconvulsive therapy (ECT) was successfully used to treat patients with prior neurosurgical history. The first patient had undergone surgery for a meningioma with subsequent insertion of a plate in the cranium. The second patient had a history of normal pressure hydrocephalus which was treated with a ventriculoperitoneal shunt procedure. Both patients received ECT and in both cases the presenting symptoms of depression abated. Treatment was considered both uneventful and successful.