Acute respiratory distress syndrome (ARDS) is a frequent cause of admission in intensive care unit. The treatment is well codified. Unfortunately some patients die because of hypoxemia despite a well-conducted medical treatment. Extracorporeal oxygenation could be the ultimate treatment for these refractory hypoxemia patients. We report two cases of patients suffering from severe ARDS who beneficiated from extracorporeal oxygenation, pointing out the interest of this technique during severe ARDS as well as the accessibility and the feasibility of the technique even apart from a specialized center.