This document describes a mobile extracorporeal membrane oxygenation (ECMO) retrieval service for patients experiencing severe respiratory failure. The service consists of an intensivist, specialist ECMO nurse, perfusionist, and ambulance crew who can initiate ECMO onsite and transport critically ill patients long distances to an ECMO center. A study of 60 patients retrieved found that 80% required ECMO initiation onsite, all were successfully cannulated, and transfers occurred over an average of 59 miles without serious complications. Patients had significantly improved oxygenation and ventilation after transfer. Survival rates to discharge from the ECMO center were 77% for those on ECMO and 75% for conventionally ventilated patients.