Background <p>This study aimed to assess the psychometric properties of the Farsi version of the Electroconvulsive Therapy-Related Anxiety Questionnaire (ERAQ).</p> Methods <p>This methodological study was conducted among patients undergoing or with a history of Electro Convulsive Therapy (ECT) in Mashhad, Iran, during 2024–2025. Data were collected using a demographic profile form and the ERAQ. The questionnaire was translated into Farsi using the forward-backward translation method, and its face and content validity were assessed both qualitatively and quantitatively. To evaluate construct validity, exploratory factor analysis (<i>n</i> = 150) and confirmatory factor analysis (<i>n</i> = 150) were performed. Convergent validity was examined using Composite Reliability and Average Variance Extracted values, while discriminant validity was assessed through the Heterotrait-Monotrait ratio. Reliability was determined by estimating internal consistency through Cronbach’s alpha and McDonald’s omega coefficients.</p> Results <p>During exploratory factor analysis, item 9 was removed because its factor loading was less than 0.30, and the remaining 16 items were distributed across three factors: life disruption, socio-physical disruption, and memory disruption, which collectively explained 45% of the total variance. Confirmatory factor analysis demonstrated a good fit for the proposed model. All composite reliability, maximum reliability, and heterotrait-monotrait ratios supported the convergent and discriminant validity of the ERAQ. Additionally, Cronbach’s alpha and McDonald’s omega coefficients confirmed the acceptable internal consistency of the Farsi version of the ERAQ.</p> Conclusion <p>Based on the findings of this study, the Farsi version of the ERAQ demonstrates sufficient validity and reliability to assess anxiety symptoms associated with ECT in the Iranian population.</p>