ECMO is a therapeutic method which markedly improved the prognosis of premature or near term infants with severe cardiorespiratory insufficiency where conventional intensive care, incl. pulmonary ventilation and medicamentous support of the circulation did not help. It is method which needs the necessary technical equipment, perfect laboratory facilities and well trained teamwork. It is associated with risks which are not negligible, clearly defined indications as well as contraindications. The programme of ECMO, when introduced, should be regional and departments which use it should be in the area of large university hospitals. Despite the considerable costs associated with establishment of a therapeutic ECMO unit, it pays, as in the most threatened group of neonates it shortens the period these infants spend at the intensive care unit and reduces their mortality rate and severe forms of late postasphyctic morbidity.