The last 10 years have seen an exponential rise in the use of extracorporeal life support (ECLS), also frequently referred to as ECMO (extracorporeal membrane oxygenation) when a membrane lung is incorporated. One of the consequences of this rise in ECLS is the need for equipment to initiate and maintain the patient on support. This is especially true in pediatrics, as the majority of available systems are designed for adults. This review will outline changes that have occurred in the ECMO field and review current and upcoming systems which may advance the field even further. To assist in understanding the differences between devices, comparison tables are provided for ECMO systems and cannulas.