Patients undergoing liver transplantation infrequently require extracorporeal membrane oxygenation (ECMO) support. However, when ECMO is required in the peritransplant period, several key considerations are required to maximize the efficacy of its support and minimize the risks of complications. This review seeks to briefly summarize the existing data supporting the use of ECMO in liver transplant patients and offers expert technical and practical advice from the authors’ high-volume liver transplant center and ECMO program.