Thirty-two outpatients with a mean age of 68 years were observed in a naturalistic study of outpatient electroconvulsive therapy (ECT) for the management of recurrent mood disorder. Sixty-nine percent of the patients responded favorably to ECT and were either discharged well from therapy or continue in treatment. A rehospitalization rate of 9% supports the efficacy of this treatment. We find outpatient ECT safe for the long-term management of recurrent depressive illness in elderly patients. The low dropout rate demonstrates that patient acceptance is equal to that of other outpatient treatments.