Abstract: Achieving return of spontaneous circulation and improving survival during out-of-hospital cardiac arrest (OHCA) is challenging. It has been established that extracorporeal cardiopulmonary resuscitation (ECPR) can be an alternative rescue therapy when conventional cardiopulmonary resuscitation (CCPR) fails to re-establish circulation. Pre-hospital ECPR can reduce the time of inadequate circulation as much as possible. However, the implementation of pre-hospital ECPR needs huge investment, and due to the limitations of site conditions, clinical promotion and application are difficult. Therefore, team cooperation, implementation process and the best beneficiaries of the pre-hospital ECPR still need further study. At present, some medical institutions at home and abroad have carried out the pre-hospital ECPR strategy and achieved some success. Herein, we review the current situation and the prospect of applying prehospital ECPR.