Electroconvulsive therapy (ECT) in the presence of metal in the skull may cause concern among clinicians. The literature is sparse, with only a few case reports in this area. We present here a case where ECT was administered in a patient with metallic internal fixation for the fracture of mandible. The 37-year-old man presented with severe depression, suicide risk, and alcohol dependence. Administration of ECT was uneventful, with no complications during ECT or at follow-up; and there was successful resolution of symptoms. This case report demonstrates that ECT may be safe in the presence of metallic implants in mandible.