Acute respiratory distress syndrome (ARDS) is a common clinical critical illness, which is usually treated with lung protective ventilation stratagy. It?s still difficult to correct hypoxemia and hypercapnia in some severe patients, who are also prone to barotrauma and have a higher mortality rate. Extracorporeal membrane oxygenation (ECMO) can completely or partially support cardiopulmonary function, showing many advantages in treating severe ARDS, such as reducing ventilator induced lung injury, correcting hypoxemia and assisting weaning. Although there is no certainty with the outcome of ECMO patients and ECMO brings about a higher treatment risk and cost, the application of ECMO still shows a more broad prospect with improvement of technique and accumulation of experiences.