Psychiatric disorders during pregnancy pose a great challenge. Both medications and maternal mental illness may have adverse effect on the fetus and the balance between risks and benefits of treatment strategy is crucial. Electroconvulsive therapy (ECT) is known to have few adverse effects and therefore it may be preferred. We report on a 31-year old pregnant woman at 36 weeks gestation, who had a history of bipolar I disorder and who was admitted for manic episode with psychotic features. Due to her persistent manic symptoms and on consideration of the teratogenic risks of psychotropic drugs to the fetus, electroconvulsive therapy was recommended. The electroconvulsive therapy was administered three days after admission and improvement of disease condition was noted. The delivery was performed by Caesarean section, and no complication was reported. Electroconvulsive therapy use in psychiatric disorder during pregnancy is a relatively effective and safe treatment.