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• ECMO has been used as a rescue therapy for severe respiratory failure and ARDS for years and ECMO should also be considered as a rescue therapy for COVID-19 with refractory hypoxemia despite lung-protective ventilation according to WHO. • Although the clinical trials of ECMO for COVID-19 are lacking, its use in COVID-19 might also offer promise based on the previous experience. • In the current situation of pandemic outbreak, many issues of ECMO use deserve our attention. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged since December 2019 in Wuhan city, and has quickly spread throughout China and other countries. To date, no specific treatment has been proven to be effective for SARS-CoV-2 infection. According to World Health Organization (WHO), management of coronavirus disease 19 (COVID-19) has mainly focused on infection prevention, case detection and monitoring, and supportive care. Given to the previous experience, extracorporeal membrane oxygenation (ECMO) has been proven to be an effective therapy in the treatment of respiratory failure or acute respiratory distress syndrome (ARDS). On the basis of similar principle, ECMO may be also an effective therapy in the treatment of severe COVID-19. In this study, we described and discussed the clinical outcomes of ECMO for ARDS patients, ECMO use for severe COVID-19 in China, the indications of ECMO use, and some important issues associated with ECMO. [ABSTRACT FROM AUTHOR]