We started to use extracorporeal membrane oxygenation (ECMO) in 1986. Since then, ten critical cases of congenital diaphragmatic hernia (CDH) have been managed with ECMO. A veno-arterial bypass was employed in all cases. The average age of starting was 34.3 hours old, and the average ECMO time was 96.3 hours. Seven out of 10 infants survived. We believe ECMO is most beneficial in the management of critically ill patients with CDH, particularly to overcome the condition of persistent fetal circulation.