Despite advances in treatment, acute respiratory distress syndrome (ARDS) remains a common cause of respiratory failure requiring ventilatory support and is associated with significantly high rates of morbidity and mortality. To date, the only treatment shown to increase survival rate in patients with ARDS is the use of supportive mechanical ventilation using low tidal volumes. Extracorporeal membrane oxygenation (ECMO) is a therapy that has been used in severe cases of ARDS when patients fail to improve with traditional management. Recent literature shows varying mortality rates for the use of ECMO for ARDS; however, the literature suggests that transfer of patients to an ECMO center for treatment using specific criteria and indications may improve outcomes. Further research is needed regarding the timing of the initiation of ECMO, standardization of therapy, and which type of ECMO reduces morbidity and mortality rates in patients with ARDS.