Venovenous extracorporeal membrane oxygenation (VV-ECMO) is quickly becoming a method to bridge patients with advanced pulmonary disease to lung transplantation. Historically, pediatric hospitals have more in-depth experience with the use of ECMO; however, bridging children with this method of respiratory support to lung transplantation is carried out infrequently with limited reported experiences in the medical literature. This article describes the optimal use of ambulatory VV-ECMO in two adolescent patients who were bridged to lung transplantation aided by tracheostomy placement.