Delusion of pregnancy is a special form of hypochondriacal / somatic delusion. High potency antipsychotics such as pimozide are indicated in the treatment of delusional disorder. However, the use of Modified Electroconvulsive Therapy (MECT) in delusional disorders has been reported infrequently. We report a case of a 38 years old femalewho presented to the department of Emergency Medicine and then later referred to the Department of Psychiatry. History and mental status examination in the Emergency Department revealed pre-morbid paranoid traits, bad obstetric history and significant interpersonal stressors with her only child and a delusion of pregnancy. A diagnosis of persistent delusional disorder (ICD10) was made. In view of significant hostility and acting out behaviour MECTS were initiated along with antipsychotic Pimozide. Serial evaluation of symptoms was done. The case highlights the successful encapsulation of a delusional belief with MECT and also discusses the psycho-social factors that might have contributed to the evolution of this delusion.