WE present two cases of the use of veno-venous extracorporeal membrane oxygenation (VV-ECMO) during resection of obstructing tracheal papillomata. Conventional anesthesia techniques may be unsafe with near obstructing papillomatous disease of the trachea. The advantage of ECMO in this circumstance is that gas exchange can be totally supported for the duration of the procedure while at the same time providing an apneic unobstructed surgical field. There are reports of the use of ECMO during surgery for tracheal obstruction and resection in neonates and children but to our knowledge this is the first account of its use in adults.