A 27-year-old female presented at 23 weeks 6 days gestation that tested positive for the coronavirus disease 2019 (COVID-19). Despite mechanical ventilation and paralysis, she remained hypoxic and was emergently cannulated for veno-venous extracorporeal membrane oxygenation (VV ECMO). The patient ambulated while intubated and on VV ECMO. She was decannulated and extubated. An ultrasound demonstrated an appropriately grown fetus without abnormalities. She was discharged to home and gave birth to a healthy baby girl at 39 weeks gestation. Utilizing VV ECMO, this patient and her fetus survived acute hypoxemic respiratory failure due to COVID-19.