Aims and method Electroconvulsive therapy (ECT) prescription rates in Scotland are decreasing. This study aims to look for possible causes, in particular psychiatrists' attitudes. Ninety-one Scottish psychiatrists completed a survey in 2009 relating to demographics, training, current practice, National Institute for Health and Care Excellence (NICE) guidelines and attitudes. Results The mean number of times the psychiatrists had prescribed ECT in the past 2 years was twice. About 43% felt that their prescribing rates had decreased. Reasons for this included more effective medication, public and patient perception, and NICE guidelines. There was a significant correlation between doctors' gender and estimated prescription rates (P = 0.004), however, not with other prescription data. Almost all surveyed psychiatrists (97%) agreed that ECT has a place in current psychiatric practice. Clinical implications Despite generally positive attitudes to ECT shown by psychiatrists in this study, prescription rates were low and decreasing. With more effective medication the role of ECT in therapy appears to be changing. Declaration of interest None.