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Depression is a condition that can present with varied signs and symptoms. Physical pain, although not stated as a symptom of depression according to the official psychiatric classification systems of the Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases, 10th revision, is also frequently reported by patients with depression. Physical symptoms, common in major depression may lead to chronic pain, often complicating treatment and is generally accompanied by a significant level of dysfunction. A multi-pronged approach often becomes necessary in such patients. They are amenable to numerous strategies including cognitive behavioral therapy (CBT), pharmacotherapy and in some resistant cases electroconvulsive therapy (ECT) also becomes an effective treatment approach. The use of ECT becomes even more pertinent in patients who fail to achieve remission despite being treated with CBT and various pharmacological regimens. We hereby report a case of a 61-year-old man with depression, presenting with pain abdomen as a part of recurrent depressive disorder who eventually responded to the use of ECT as a therapeutic modality. The potential role of the dose of the anesthetic agent influencing the efficacy of the ECT has also been highlighted.