Extracorporeal membrane oxygenation (ECMO) has been used since 1975 to provide temporary cardiorespiratory support in neonates, children, and adults with severe cardiopulmonary conditions unresponsive to conventional therapy. Initially focused on neonatal respiratory failure, ECMO indications have expanded to include older children with cardiac failure or post-cardiopulmonary arrest. Epidemiological data indicate a decline in neonatal respiratory ECMO cases over the recent decades, largely due to advances in conventional therapies. Conversely, neonatal cardiac ECMO has shown a more variable trend, often used perioperatively in congenital heart disease or for myocarditis, cardiomyopathy, and refractory arrhythmias. Survival rates remain relatively stable, although outcomes vary with underlying pathology and disease severity. Long-term follow-up of survivors reveals persistent respiratory, neurodevelopmental, and motor sequelae, particularly in patients with complex or chronic conditions such as congenital diaphragmatic hernia or hypoxic-ischemic encephalopathy. Pulmonary function deficits, cognitive impairments, hearing loss, and motor delays are frequently reported, with earlier rehabilitation and structured follow-up programs shown to improve functional recovery. Multicenter registries highlight the need for standardized assessment protocols to track long-term outcomes and guide interventions.