We report a case of a patient with chest trauma (TT) complicated with severe acute respiratory distress syndrome (ARDS) who required extracorporeal membrane oxygenation (ECMO) as ventilatory support. Clinical case: A 48-year-old man, with no relevant history, after a high-energy vehicle collision admitted with severe TT. He evolved with respiratory failure that required intubation and connection to mechanical ventilation (MV). He persisted with high ventilatory requirements, requiring rescue ECMO and transfer to our center. He evolved with gasometric and ventilatory improvement that allowed disconnection on the ten day. There were no bleeding or thrombotic complications during ECMO. Discussion: ECMO support is complex, expensive, and is performed in high-risk patients. The use of this resource requires trained health workers. Its use must be highly selective, constituting a valuable support tool in some patients with severe ARDS secondary to TT.