Extracorporeal membrane oxygenation (ECMO) is an invaluable tool in cardiac surgery. In pediatric patients, it is almost exclusively deployed by congenital cardiac surgeons who are sufficiently trained. Pediatric ECMO can be used for both respiratory and circulatory failure in all age groups. Due to the limitations faced by the small patient size, the neck vessels are particularly useful for ECMO cannulation and are the cannulation site of choice in small children. Pediatric veno-arterial ECMO has several details that one must be aware of for a successful ECMO run. Our aim is to provide a quick and easy go-to technical guide in pediatric ECMO for the congenital cardiac surgeon.