Obsessive-compulsive disorder (OCD) is characterized by the presence of obsessions, compulsions, or both, which is time consuming and causes significant functional impairment. The treatment options for obsessive-compulsive disorder include medication and psychological therapy. Electroconvulsive therapy (ECT) stands as an effective treatment for severe and treatment-resistant psychiatric conditions. However, there is still insufficient evidence regarding the efficacy of ECT in OCD. We intend to report a case of a middle-aged woman who suffered from severe and refractory OCD who showed promising response following her ECT. Patient showed symptoms of relapse one month after the completion of ECT which led to the re-initiation of another acute series of ECT. Despite achieving improvement in symptoms, the patient experienced a distressing post ECT delirium. Even though the delirium was resolved after one week, the patient was not keen to continue with ECT. ECT emerges as both a safe and effective option for severe and refractory OCD, particularly in cases where conventional treatments prove ineffective. As of yet, the exact mechanism of how ECT works is unexplained, and the value of ECT in OCD should be further investigated.