Lung-protective ventilation strategies are currently one of the standard treatments for patients with acute respiratory distress syndrome in an effort to provide adequate ventilatory requirements while minimizing ventilator-induced lung injury.With the in-depth understanding of ventilator-induced lung injury,more attention has been paid to the changes in the indicators of driving pressure,strain,transpulmonary pressure,mechanical power and in other indicators.Ultra-lung-protective ventilation can achieve lower tidal volume and airway pressure but better lung protection.Because application of ultra-lung-protective ventilation is often limited by respiratory acidosis,extracorporeal life support,represented by extracorporeal membrane oxygenation and extracorporeal carbon dioxide removal technology,is the key to ensuring the implementation of ultra-lung-protective ventilation.This article briefly describes the feasibility and effectiveness of ultra-lung-protective ventilation under extracorporeal life support and summarizes the main points of its implementation and existing problems,aiming to enhance our understanding of ultra-lung-protective ventilation and propose areas of future research.