Objective To evaluate the effect of extracorporeal membrane oxygenation (ECMO) combined with intraaortic balloon counterpulsation (IABP) on patients with acute left main coronary artery disease. Methods 3 patients suffered from acute left main coronary artery disease and timely supported by ECMO combined with or without IABP were reviewed. Results With the assistance of ECMO and/or IABP, all of the 3 patients had successfully undergone coronary angiography and coronary revascularization. The first case was performed percutaneous transluminal coronary angioplasty (PTCA) with stents placement; the second was performed coronary artery bypass grafting (CABG); the third case was performed PTCA and CABG. All patients were weaned off ECMO. 2 patients were discharged, whereas the other one died 1 month after CABG. After 6~24 months follow-up, 2 survivors had good quality of life. Conclusion Efficient ECMO support with or without IABP might offer opportunities for the following revascularization on patients with acute left main coronary artery disease.