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Abstract: Objective: The main objective is to describe and analyse hospital costs of the extracorporeal membrane oxygenation (ECMO) procedure. Study sample and methodology: Between January and December 2007, 14 ECMO patients were consecutively included in the study. Costs at the patient level were registered prospectively, while overhead costs were registered retrospectively. Patient costs were obtained from patient records and time–motion studies and included personnel resources, diagnostic and laboratory tests, radiology and operating room procedures, medication and blood products. Overhead costs were allocated to clinical departments and further to the individual patients by predefined keys. To achieve estimates of total costs, patient-specific costs and patient-specified overhead costs were summarised. Results: The mean estimated cost for the ECMO procedure was 73,122 USD (SD 34,786) and median 62,545 USD (range: 34,121–154,817). The mean estimated total hospital costs, including pre- and post-ECMO procedures, was 213,246 USD (SD 12,265), median 191,436 USD (range: 59,871–405,497). On average, 82% of costs for the total hospital stay were related to personnel use, and blood products constituted 7%, lab and radiology 2.5%, disposable items 3% and medication 1.5%. The mean duration of an ECMO procedure was 9.5 days (range: 4–23 days) and the average total length of stay in hospital was 51.5 days (range: 6–123 days). The cost data were converted from Norwegian kroner (NOK) to US dollars (USD), with an exchange rate of 1 USD=5.5 NOK. Conclusion: ECMO procedure is a resource-demanding procedure. [Copyright &y& Elsevier]