Drowning is a leading cause of death in children worldwide. However, there is uncertainty about the initiation and the extent of adequate therapeutic interventions after drowning accidents. As prediction of outcome in drowned children remains difficult, initial maximum life support appears to be generally justified. We present the case of a 3-year-old drowned girl in refractory cardiorespiratory arrest who was resuscitated successfully with cardiopulmonary bypass (CPB) followed by extracorporeal membrane oxygenation (ECMO) for 4 days. After a prolonged period in a vegetative state eventually she made an almost complete neurological recovery. We do not have knowledge of any case of drowning reported with a favourable neurological outcome after such a prolonged period of ECMO.