Although extracorporeal membrane oxygenation (ECMO) has become standard treatment for neonatal respiratory failure, the results of ECMO in adults have been less encouraging. With technical improvements in membrane oxygenators and revised ECMO protocols, there has been renewed interest in ECMO for adults with severe acute respiratory failure. However, few cases of ECMO as an adjunct to adult lung transplantation have been reported. We present the case of a 20-year-old woman with cystic fibrosis who underwent bilateral single lung transplantation. She had development of severe graft dysfunction in the immediate postoperative period requiring support with ECMO for stabilization.