OBJECTIVE: Hoarding disorder is characterized by excessive collecting or hoarding and is associated with excessive acquisition and inability to dispose of certain objects, regardless of their material value. These objects, which are collected or accumulated with the thought that they can be useful in the future, can be piled up in living spaces and cause some important medical and social problems. Although hoarding has been defined in the literature for more than a century, it was first defined as a separate diagnostic category under the headings of obsessive compulsive disorder (OCD) and OCD-related disorders in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition). In this article, a case who was hospitalized in our clinic with the diagnosis of hoarding disorder and treated with medical and electroconvulsive therapy (ECT) is presented. CASE: The 39-year-old female case, according to herself, felt empty in her stomach, believed that her stomach emptied quickly, had fear of going hungry when she did not eat bread; According to his relatives, he applied because of the complaints of constantly eating bread and hoarding objects such as bread, napkins, bags and newspapers. From his story, it was learned that his complaints started 7 years ago, that he consumed excessive bread, and that he collected objects such as bread, newspapers, bags and napkins. In her mental examination, her attention-care was decreased and her emotions were anxious. Associations were regular, perception, memory and orientation were normal. His insight was bad. The Yale-Brown Scale total score was 34. The patient was given medical treatment with sertraline 200 mg/day, clomipramine 75 mg/day, and aripiprazole 15 mg/day for 8 weeks. Medical treatment was supported with 9 sessions of electroconvulsive therapy (ECT). It was observed that the feeling of emptiness in the stomach, the belief that the stomach empties quickly, the fear of being hungry when not eating bread, which are included in the thought content of the electroconvulsive treatment, disappeared, the hoarding behavior was absent, and the Yale-Brown Scale total score decreased to 4. DISCUSSION: Hoarding is driven by fear of losing objects that he may need later, false beliefs about them, and emotional attachment. They often do not have insight into their situation and resort to treatment under the compulsion of their relatives. Although there are studies with CBT and SSRIs in treatment, studies on this subject are not sufficient. In our case, a positive result was obtained regarding the effectiveness of electroconvulsive therapy together with medical therapy in hoarding disorder with poor insight. However, more research is needed on this subject.