In 2025, clinical research in extracorporeal life support (ECLS) has further advanced the precision and individualized application of cardiac and respiratory support strategies. In the field of cardiac support, identification of patients most likely to benefit from veno-arterial extracorporeal membrane oxygenation (VA-ECMO) increasingly relies on comprehensive assessment using multiple hemodynamic parameters, while bundled management strategies incorporating standardized physiological targets have shown clinical outcomes. The recommendation level for microaxial flow pumps in patients with ST-segment elevation myocardial infarction (STEMI) complicated by severe cardiogenic shock has been upgraded. In addition, extracorporeal cardiopulmonary resuscitation (ECPR) emphasizes rapid deployment and precise patient selection. In terms of respiratory support, the indications for veno-venous extracorporeal membrane oxygenation (VV-ECMO) in severe trauma, lung transplantation bridging and other clinical settings have been further clarified. Prone positioning during ECMO support has been shown to reduce mortality in selected patients with acute respiratory distress syndrome (ARDS), although attention to complications such as thrombocytopenia remains essential. Furthermore, standardized weaning protocols may help shorten ECMO duration. Artificial intelligence also contributes to more precise ECMO management. In summary, advances in ECLS research in 2025 underscore the growing emphasis on precision medicine and individualized management, while highlighting the need for further clinical investigations to optimize patient selection and improve prognosis. This article reviews the latest clinical research findings in the field of ECLS for the year 2025, providing up-to-date evidence-based medical evidence for clinical practice.