ECT is an innovative, relatively new technique for the local treatment of deep-seated malignancies. Its mechanism of action relies on the chemotherapeutic agent and permits the use in otherwise inaccessible regions, e.g. close to the hilum of the liver. The current evidence is limited but rapidly growing. It is a reasonable addition to the treatment of liver and soft tissue tumours, particularly in the salvage setting, but can also be used upfront if the risk for other treatments including surgery and thermal ablation is considered inacceptable. The treatment is well tolerated and complications are rare.