We present a case in which veno-venous extracorporeal membrane oxygenation (VV-ECMO) was implemented, along with general anaesthesia, for resection of a large endotracheal tumour obstructing the airway just proximal to the carina. To control oxygenation prompt implementation of ECMO was instituted under sedation before induction of general anaesthesia. The advantage of ECMO was demonstrated in a challenging situation where mechanical ventilation of the lungs was impossible. Airway obstruction at the level of the carina poses a great challenge to every anaesthetist. There are few case reports on the successful use of ECMO during procedures involving the difficult airway [1][2][3]. As far as we are aware this is hte first case report describing the use of ECMO to facilitate bronchoscopic resection of a tumour at the level of the carina causing near complete airway obstruction.