Background: Guillain-Barré syndrome (GBS) is an acute immune-mediated disorder that leads to progressive muscular weakness, autonomic dysfunction, and potentially respiratory failure. Case Report: A 41-year-old Caucasian man presented with progressive bilateral ascending weakness, concerning for GBS, accompanied by rapidly worsening respiratory status. Chest imaging revealed multiple causes of acute hypoxemic respiratory failure. This is the first reported case of GBS supported by veno-venous extracorporeal membrane oxygenation (V-V ECMO) during recovery and discharge. Conclusion GBS is typically associated with a high likelihood of recovery, but carries increased mortality in patients who develop sepsis, acute respiratory distress syndrome, or thromboembolic events. V-V ECMO support facilitated lung recovery and hospital discharge for rehabilitation.