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Independent lung ventilation is an infrequently used ventilation strategy in the pediatric intensive care unit but can be beneficial in unique patient subsets, such as patients who have asymmetric pulmonary pathology. Independent lung ventilation allows for the independent delivery of the appropriate effective tidal volume to each lung on the basis of individual compliance and pathology. In theory, it may help avoid alveolar overdistension and ventilator-induced lung injury in the nondiseased lung. In addition, it allows for targeted interventions. Here, we describe a child with unilateral lung disease requiring veno-venous extracorporeal membrane oxygenation who rapidly improved, allowing decannulation within 24 hours, after the application of independent lung ventilation and unilateral surfactant administration.