OBJECTIVE: To describe physical function, leg complications and health-related quality of life (HRQOL) in the three months following extracorporeal membrane oxygenation (ECMO) pre- or post-heart transplantation (HTx). BACKGROUND: Little is known about functional recovery following ECMO before or after HTx. METHODS: A 2-year retrospective study in patients who received ECMO pre or post HTx. Strength, mobility, leg complications and HRQOL were recorded to hospital discharge. Six-minute walk distance (6MWD) was assessed at hospital discharge and 3 months. RESULTS: 25 patients were included, with 80% (20/25) survival to hospital discharge. At ICU discharge, strength and mobility were poor but improved by hospital discharge (p < 0.001) despite leg complications in 44% (11/25) of patients. The 6MWD improved over time (mean 203 m, 95% confidence interval 140-265). HRQOL scores were lower than Australian norms (p < 0.05). CONCLUSION: Patients requiring ECMO pre or post HTx had impaired physical function at ICU discharge and leg complications were common. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.