Background: This study aimed to evaluate the efficacy of Electroconvulsive Therapy (ECT) in patients with Major Depressive Disorder (MDD), Bipolar Disorder (BD), Schizophrenia, and Acute Mania, focusing on symptom improvement, response rates, and adverse effects.Materials and Methods: A hospital-based longitudinal follow-up study was conducted over 12 months, involving 100 patients diagnosed with psychiatric disorders. ECT was administered according to standard guidelines. Symptoms were assessed using the Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS), and Positive and Negative Syndrome Scale (PANSS) at baseline, post-ECT, and during follow-up visits for six months. Statistical analysis was performed using SPSS software.Results: ECT led to significant reductions in symptom scores across all disorders (p < 0.001). The response rates were 80% for MDD, 72% for BD, 60% for Schizophrenia, and 73% for Acute Mania. Adverse effects were mild, with transient memory loss (15%) being the most common. Follow-up data revealed sustained improvement in symptoms over six months.Conclusion: ECT is a highly effective and safe treatment for various psychiatric disorders, showing substantial symptom reduction and sustained improvement over time. While mild adverse effects were noted, their overall impact was minimal, supporting the long-term use of ECT for treatment-resistant psychiatric conditions.