A i m : The aim of this paper is to introduce the case of prolonged resuscitation with the use of mechanical device, conducted in hypothermic patient. C a s e s t u d y : We report a case study of 48-year-old male in severe hypothermia (19°C) and active gastrointestinal bleeding. We have conducted prolonged CPR for 142 minutes together with noninvasive core warming techniques that resulted in conversion of pulseless electrical activity to ventricular fibrillation and achievement of return of spontaneous circulation. Despite proper treatment, patient died next day in Intensive Care Unit due to the multi-organ failure. R e s u l t s a n d d i s c u s s i o n : Cardiac arrest in case of severe hypothermia can lead to survival with good neurologic outcome, however prolonged cardiac arrest results in hypoxic brain injury and severe neurological dysfunction. It is crucial to initiate effective chest compressions to maintain minimal cerebral blood flow. Mechanical devices can be implemented in such situations in order to provide efficient CPR.C o n c l u s i o n s : Cardiac arrest due to hypothermia can lead to extension of resuscitation. To improve survival of patients in situations requiring prolonged resuscitation, mechanical devices performing chest compressions should be implemented. It is possible to successfully warm up hypothermic cardiac arrest patients through noninvasive methods.