Acute airway compromise, respiratory failure, and cardiogenic shock are life-threatening emergencies. Extracorporeal membrane oxygenation (ECMO) support is critical in these situations, providing both circulatory and respiratory support when conventional treatment are unsuccessful. This chapter explores ECMO’s applications, including its role as a bridge to recovery or a bridge to decision while determining long-term support options for patients with acute heart failure and cardiogenic shock. Furthermore, this chapter discusses ECMO’s use as a bridge to lung transplantation in cases of end-stage lung disease. It provides a comprehensive overview of ECMO, covering indications, maintenance, weaning protocols, potential complications, and expected outcomes, serving as a valuable resource for clinicians managing these critical conditions.