The authors present new data & review clinical experience that indicate that electroconvulsive therapy (ECT) often exerts a profound short-term beneficial effect on suicidality. They argue that little, if any, evidence supports a long-term positive effect of ECT on suicide rates. They also find that on the whole, the published reports are weakened by methodological shortcomings, such as lack of controls, weak design, & possible cohort effects. (42 refs)