Neurological outcome and quality of live are of uttermost interest in survivors of cardiac arrest. Assuming acceptable rates of return of spontaneous circulation, the long-term effects on neurological function and quality of live after cardiopulmonary resuscitation remain unsatisfactory. Extracorporeal cardiopulmonary resuscitation (eCPR) can reduce low-flow times and therefore provide adequate cerebral tissue perfusion and oxygenation. This may improve favorable outcomes after cardiac arrest. Due to the risk of procedure related complications and ethical issues, this technique should be only performed in selected patients by specially trained and experienced teams. In this review we aimed at providing an insight into the sparse evidence in this field and discussing ethical issues associated with the use of eCPR.