Airway obstruction by cervical or chest tumours yields high mortality and poses a significant challenge in airway management. Vevo-venous extracorporeal membrane oxygenation (VV-ECMO) has played a role as a bridging strategy for patients with a surgical indication. This case report presents a difficult airway caused by a thyroid lymphoma, managed successfully with VV-ECMO and cytoreductive treatment, where surgery was not warranted. The report focusses on the pivotal role of VV-ECMO in providing respiratory support beyond surgical scenarios, adding a new dimension to airway management, allowing the multidisciplinary team valuable time to outline and establish a definitive airway.