Extracorporeal membrane oxygenation (ECMO) is the short-term (days to weeks) 
support of patients with severe respiratory and/or cardiac failure. The use of 
these devices has been well established in paediatric and post-heart and lung 
transplantation patients; however, its use in patients with severe acute 
respiratory distress syndrome (ARDS) has gained acceptance as standard clinical 
practice over the past decade. The results of the CESAR trial (Conventional 
ventilation or ECMO for Severe Adult Respiratory failure) showed significant 
survival benefit for patients with ARDS undergoing ECMO. Substantial numbers of 
radiological examinations are performed in this patient group, prompting the 
need for general radiologists to understand the radiological appearances of 
these devices and associated complications. In this review, we highlight the 
uses, subtypes, physiology, normal appearances, and complications of ECMO. An 
example of the chronological radiographic images in the perioperative period 
demonstrates the importance of discriminating normal appearances associated with 
EMCO.