Speaking at the Physician’s Update Conference in Cape Town in February 2018, Dr Calligaro provides a definition of ECMO and explains the components of ECMO and how it works. He provides information on how ECMO came to the fore in the treatment of viral pneumonia and how the H1N1 epidemic saw an upsurge in the use of ECMO. Patient selection and timing is crucial, and Dr Calligaro presents on how to select patients for VV-ECMO and on the tools to predict the outcome of VV-ECMO. This presentation also explores several studies around ECMO.