Extracorporeal membrane oxygenation (ECMO) is becoming more frequently used in ICU settings. The use of ECMO can help the heart recover or serve as a bridge for a patient waiting heart transplantation and or adequate gas exchange, allowing time for the lungs to recover. The disadvantages to ECMO include cost, staffing issues, and increased complications related to treatment. The observation of all organ systems and thorough assessments can help lead to positive outcomes. The ICU nurse is a key component of the ECMO team in providing quality care to a patient with ECMO. The understanding of ECMO and the prevention of complications are key components when caring for these critical patients. This paper will make reference to the care of patients with ECMO.