The survival of cardiac arrest patients is dependent on the efficient and timely application of the chain of survival. This includes early identification of cardiac arrest and activation of the emergency response system, high-quality cardiopulmonary resuscitation (CPR), rapid defibrillation, basic and advanced medical services, and advanced life support and post-cardiac arrest care. However, some patients may be refractory to these measures. Extracorporeal membrane oxygenation CPR (ECPR), otherwise known as extracorporeal life support, offers an alternative to such refractory cardiac arrest cases. As hospitals have limited resources, it is important to devise effective patient selection methods, and improve our understanding and experience of ECPR to ensure the best outcome. It is also vital to understand that ECPR constitutes only one component of post-cardiac arrest care, which includes other aspects such as therapeutic hypothermia and early perfusion for best patient outcome.