Abstract： @@ Microscopic polyangiitis (MPA) is characterized by an inflammatory process of the vessel walls and is classified according to the smallest vessels involved. Diagnosis is based on clinical manifestations, anti-neutrophil cytoplasmic autoantibody (ANCA) testing, and histology. In this disease, pulmonary hemorrhage is seen in 30% of patients and is associated with an eight-fold increase in mortality. Classically, MPA involves the kidneys and upper and lower respiratory tracts. Due to the perceived risk of increased bleeding secondary to the use of systemic anticoagulation, extra corporeal membrane oxygenation (ECMO) is often not used to treat patients with hemorrhage suffered from MPA. Here we report a case of a 50-year-old woman with MPA that was successfully supported with ECMO.