Abstract Background: History of adverse childhood experiences (ACEs) is associated with poorer treatment outcomes in depression; this has been found for psychotherapy, pharmacotherapy, and their combination. However, how ACEs affect neuromodulation outcomes, such as repetitive transcranial magnetic stimulation (rTMS), remains unexplored. Objective: Characterize the prevalence of ACEs in patients receiving rTMS for depression at a tertiary care centre in Canada. Investigate whether ACEs affect depression outcomes in these patients. Methods: The Hamilton Depression Rating Scale, HAMD-17) was collected at baseline and every 2 weeks until the end of treatment at 4-6 weeks. The primary outcome was remission (HAMD-17 of 7 or less). The ACE-10 questionnaire was used to quantify categories of ACEs. Data from the first round of treatment from 94 patients with ACE-10, baseline and end-of-acute treatment HAMD-17 scores were included in analyses. Results: Patients had a median of 2 and mean of 2.9 ACEs (range 0-10, standard deviation 2.7). 78% had at least 1, 63% at least 2, 48% at least 3, and 35% at least 4 ACEs. Remission rates at end-of-acute treatment were not significantly different between low and high ACE groups (2 or fewer vs 3 or more ACEs; 9/49, 18% and 12/45, 27% respectively; chi2 = 0.93, p = 0.34). Logistic regression using ACE-10 or its sub-scales revealed no significant deleterious effects of total score, abuse, neglect, or household dysfunction on remission. Linear mixed models of longitudinal data revealed similar decreases in HAMD-17 from baseline over time that did not significantly differ based on ACE score. Conclusions: Patients with depression receiving rTMS at a tertiary care centre in Toronto, Canada reported on average 3 ACEs. ACE scores were not predictive of poorer antidepressant outcomes from acute treatment with rTMS for depression. Presence of high levels of ACEs should not preclude consideration of rTMS for depression. Keywords: adverse childhood experience, childhood maltreatment, transcranial magnetic stimulation, major depressive disorder