The management of a patient placed on extracorporeal membrane oxygenation (ECMO) is a team effort. The anesthesiology team plays an integral part during cannulation and oftentimes as well during decannulation. In addition, the management of a patient taken to the operating room on ECMO requires a degree of expertise. This chapter will review monitors, echocardiography, medications, fluid and blood management protocols, and ventilation strategies to help the anesthesiology team provide best care for this patient population.