Summary: A case of neuroleptic malignant syndrome (NMS) successfully treated with electroconvulsive therapy (ECT) is presented and the literature on this subject is summarized. The possibility of an etiologic link between catatonia related to a psychiatric disorder and NMS is explored. Possible relationships between NMS and lethal catatonia are explored. ECT may be a useful treatment in selected cases of NMS, especially those with evidence of a preexisting ECT responsive disorder.