Purpose of Review <p>Extracorporeal membrane oxygenation is becoming increasingly employed as a bridge to lung transplantation patients with end-stage lung disease. Significant advancements in technology and expertise have expanded the pool of potential lung transplant candidates. This review summarizes modern data demonstrating improved outcomes with use of extracorporeal membrane oxygenation as a bridge to lung transplantation and explores strategies for managing complex clinical scenarios.</p> Recent Findings <p>The use of extracorporeal membrane oxygenation as a bridge to lung transplant has improved significantly in survival over time. Additional important outcomes, including physical mobility, hospital length of stay, and duration of intubation following transplant, support non-intubated bridging on extracorporeal membrane oxygenation.</p> Summary <p>Extracorporeal membrane oxygenation as a bridge to lung transplantation is improving as a modality to support end-stage lung disease unresponsive to conventional therapies. Increasing complexity of lung transplant candidates will demand increased expertise in this modality in the future.</p>