Acute airway obstruction caused by invasive laryngeal cancer can make surgeons reluctant to perform a high-risk tracheostomy, which is life-saving for such patients . In the setting of the current COVID19 pandemic, we present a case of severe transglottic stenosis due to stage IV laryngeal carcinoma, in which gaseous exchange was facilitated by venovenous (VV) extracorporeal membrane oxygenation prior to emergent tracheostomy . The VV technique can ensure adequate oxygenation and CO2 removal . Venovenous extracorporeal membrane oxygenation provided sufficient time for surgical planning and preparation . It reduced the formation of aerosol, lowered the risk associated with life-saving tracheostomy, and protected the patient from ischemia.