|Drowning is the third leading cause of unintentional accidental death globally. The most serious pathophysiologic consequence of drowning is hypoxemia from acute respiratory distress syndrome. Herein, we report a drowning victim who presented with hypothermia and cardiac arrest, followed by acute respiratory distress syndrome, rhabdomyolysis (with acute kidney injury), and disseminated intravascular coagulopathy. Aided by advanced cardiac life support and mechanical ventilation with prone position, the patient fully recovered after two days of hospitalization. As part of the complex management, mechanical ventilation in a prone position was critical to the patient``s recovery. Coupled with use of NO gas, this strategy seems far simpler and less risky than ECMO and may constitute a preferred option, with ECMO as a plan of last resort.