Cognitive impairment is the most important side effect of electroconvulsive therapy (ECT), and if detected early, modifications to treatment can be made to reduce the severity of it. Various guidelines suggest that regular, detailed monitoring of cognitive function should be routine during ECT. We hypothesize that such monitoring would be able to detect cognitive effects of ECT at an early stage but that this would require careful selection of tests to be both sensitive and practical in routine clinical practice. We review evidence regarding the sensitivity of various cognitive tests to the effects of ECT. From this, we suggest a battery and testing schedule which may be both practical and useful in early detection of the cognitive effects of ECT.