Electro Convulsive Therapy (ECT) is a medical treatment for severe mental illness in which small, carefully controlled electricity is applied to the brain. This electric stimulation is done in conjunction with anesthesia and muscle relaxant medications to produce a mild generalized seizure. This is used to treat a variety of psychiatric disorders. This is most effective in the treatment of severe depression providing a rapid relief. We report and discuss an unusual presentation of a ninety three year old lady with a diagnosis of Major Depressive Disorder, Recurrent, Severe with Psychotic features (296.34) who experienced musical hallucinations whilst she was treated on ECT. Clinically there was an inverse relationship between the biological symptoms of depression and musical hallucination during the ECT management. Though similar reports have never been reported earlier, we noticed a good association between the initiation of ECT and musical hallucination in our patient. The patient stopped experiencing musical hallucinations and improved of her biological symptoms of depression completely after the full course of ECT.