Early onset of schizophrenia spectrum disorders (SSDs), with onset of psychotic symptoms before age 18, is a severe form of the disorder that presents with more social disability and poor outcome. In general, the pharmacological treatment, as in adult onset schizophrenia, consists of antipsychotics. We use a rare treatment in child and adolescent that Clozapine and Electroconvulsive therapy. A17-year-old male patient is our case. When he was 15 years old, first symptoms of social withdrawal and impaired cognitive performance in domains such as attention, concentration, memory and planning were observed. He also experienced incoherent speech, şight of ideas, thought blocking, şat affect, bizarre behavior. He was consistently diagnosed as having schizophrenia and begun antipsychotic treatment. However, he did not have benefit with thus; he was referred to our clinic by parents. The presenting complaints included phobias, doubts, hearing voices and laughing at him. In his medical history, it was found out that the patient did not want to go out of home within prior 3 months; that he had poorer self-care and did not want to take bath; that he had not any communication with anybody and he was thinking that they would harm. He was hitting to people around without any reason. In the mental state evaluation, the patient was conscious, oriented but had difficulties in cooperation. He had limited affection and he described auditory deficit. He had prolonged reaction times, blocks and impaired ability of abstract thought. EEG and MR imaging were obtained to exclude organic reasons. Both evaluations were settled as normal. He has used aripiprazole, paliperidone and olanzapine. The patient, who had persisting delusions and hallucinations without response to three distinct antipsychotic drugs, was diagnosed as refractory schizophrenia. Thus, Clozapine was initiated to the patient, but no regression was observed in symptoms despite increasing dose up to 300 mg/day. ECT was scheduled to the patient and Clozapine dose was increased to 400 mg/day. After 11 sessions of ECT, reaction time was shortened and blocks were decreased. A partial decline was found in delusions and hallucinations with increasing communication with other people. In adolescents, clozapine has been shown to be superior to other second-generation antipsychotics (SGAs) for treating psychotic disorders. It has also been associated with a decrease in violent behavior in this population. Moreover, both a decrease in the number of hospitalization and a greater ability to live in less restricted environments have been described, when childhood-onset schizophrenia was treated with clozapine. Regarding safety, clozapine may cause adverse effects similar to other antipsychotics. Other potential adverse effects include seizures and agranulocytosis. These factors complicate the use of the drug while making it a second-line treatment for SSDs in both adolescents and adults. Clozapine was initiated to our patient, but no regression was observed in symptoms and we decided to ECT. Electroconvulsive therapy is an effective treatment for resistant schizophrenia in adults. There are several reports showing that ECT was a safe and effective treatment for some adolescents with SSDs. ECT augmentation needs further validation in child and adolescent Psychiatry. The combination of clozapine and ECT has been reported to be superior to either treatment alone. It should be considered for the treatment resistant schizophrenic patients.