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A case report of an infant with hemodynamic compromise and impending collapse due to congenital junctional ectopic tachycardia. Medical therapy was maximized and he required the rapid initiation of extracorporeal life support, in order to achieve hemodynamic stablilty.This case report briefly reviews the presentation and treatment options for congenital junctional ectopic tachycardia, as well as the indications for initiation of mechanical support for this potentially lethal condition.Congenital junctional ectopic tachycardia is a rare though often fatal arrhythmia of the newborn or infant. Medical treatment options may be limited, or may require time to attain efficacy. Despite aggressive escalation of antiarrhythmic therapy, mechanical support in the form of extracorporeal mechanical oxygenation is a viable option, until the arrhythmia is well controlled and the myocardium recovers function.