We report a case of H7N9 avian influenza pneumonia in a pregnant woman who developed acute respiratory distress syndrome (ARDS) managed with extracorporeal membrane oxygenation (ECMO). A 29-year-old, 27 week pregnant woman developed rapidly progressive pneumonia with bilateral infiltrates on chest x-ray and was confirmed to have influenza A (H7N9) infection. Her condition deteriorated and she developed ARDS which was managed with veno-venous extracorporeal membrane oxygenation (V-V ECMO) and treated with antimicrobials. Her clinical symptoms and oxygenation gradually improved and the ECMO was discontinued on the 19t day. Unfortunately, she suddenly died a few days later, due to a presumed pulmonary embolism. Based on our experience, ECMO may be useful to manage pneumonia due to H7N9 avian influenza and ARDS in pregnant women.