The study of psychiatric disorders co-occurring with rare genetic syndromes has important therapeutic and pathophysiological implications. Electroconvulsive therapy (ECT) in schizophrenia with comorbid Marfan syndrome is challenging in view of multiorgan involvement. We report successful use of ECT in a patient who presented to us with catatonia and Marfan syndrome. The report highlights the importance of careful evaluation of patients with schizophrenia and Marfan syndrome before ECT in liaison with other specialties.