This report describes three neonates who were supported with extracorporeal membrane oxygenation before surgical correction of total anomalous pulmonary venous connection. Extracorporeal membrane oxygenation was initially used to treat preoperative end-organ failure and suspected persistent pulmonary hypertension. All patients underwent surgical correction of total anomalous pulmonary venous connection after 8, 4 and 4 days of preoperative support, respectively. Two of these patients required extracorporeal membrane oxygenation after surgery; one died from bleeding while the other was weaned from extracorporeal membrane oxygenation on day 8 and discharged from the hospital. These results show that veno-arterial extracorporeal membrane oxygenation represents a life-saving perioperative means for supporting moribund neonates with total anomalous pulmonary venous connection and is effective in improving preoperative patient's condition.