Background: Despite apparent advances in the medical management of AMI, AMI complicated with cardiogenic shock remains associated with a high mortality rate. Herein we analyze the outcome for these critical patients refractory to conventional treatment who were necessitating ECLS. Methods and Results: Retrospective review of our 3 year experience. Between 2005 and 2007 inclusively, 17 consecutive patients(mean age: 64.5짹7.6, male/female: 7/10) were enrolled in this study. left main trunk and proximal-LAD lesion on initial coronary angiography were 82.4%(14/17). 11 patients(64.7%) underwent intubation for respiratory failure and temporary CPR for cardiovascular collapse before initiation of ECLS and the CPR duration before ECLS was from 25 to 95min.(mean: 62.5짹26.8). 13 patients(76.5%) received IABP before ECLS. The duration of ECLS was from 4 to 660h(mean 127 짹 146.7h) with a maximum bypass flow of 2.8 to 4.8 L/min. Total weaning rate of ECLS was 52.9% (9/17) and in-hospital survival was 35.3% (6/17). All survivors underwent successful revascularization after placement on ECLS. The cause of death in 11 patients was renal failure in six, ineffective ECLS in one, pulmonary hemorrhage and UGI bleeding in one and recurrent cardiovascular collapse after weaning from bypass in three. Conclusion: ECLS can provide ultimate circulatory support during resuscitation and for cardiovascular collapse associated with AMI.