Introduction: Extracorporeal membrane oxygenation (ECMO) has been used for cardiac and respiratory failure for over 30 years. Recently, however, veno-venous (VV) ECMO has emerged as a useful means of short-term support in hypoxic patients for nontraditional indications such as upper airway surgery and malignant airway obstruction. There were few reports for airway security in ECMO. Objectives To review our experience of using VV ECMO as a bridge to support a patient with severe airway obstruction. Methods: A total of 113 VV ECMO were performed in the Asan Medical Center from January 2009 to June 2012. 19 VV ECMO (18 patients) were used as a bridge to support a patient with severe airway obstruction and their clinical courses were reviewed. Results: Of the 18 patients, 13 were male; their mean age was 52.5 years (range 16-82). The cause of using ECMO for airway security were malignant mass removal with rigid bronchoscope (8 cases), insertion of tracheal stent (7), removal of tracheal stent with rigid bronchoscope due to stent rupture (2), debulking operation of anterior mediastinal mass with tracheal invasion (1), and emergent intubation (1). A mean ECMO time was 27.8±29.9 hours, respectively. One hemorrhagic complication was developed and he was expired due to massive bleeding after removal of malignant mass. Weaning from ECMO therapy was success in 18 cases. Conclusions: VV ECMO could be a potential option for airway security in life-saving procedures such as removal of endobron-chial mass or insertion of tracheal stent.