OBJECTIVE: This study aimed to determine the impact of hospitals' extracorporeal membrane oxygenation (ECMO) procedure volume on inpatient outcomes in patients receiving ECMO after cardiac surgery. METHODS: The records of patients in the United States Nationwide Inpatient Sample database ⩾18 years old who underwent cardiac surgery and received ECMO postoperatively from 2005 to 2020 were retrospectively analyzed. Associations between hospital ECMO volume, demographical and clinical variables, and in-hospital mortality, non-routine discharge, hospital costs, acute organ failure, and infection/sepsis were examined. RESULTS: Data of 1465 patients hospitalized in 892 hospitals were analyzed. There were 102 high ECMO-volume hospitals and 790 low ECMO-volume hospitals. Patients treated in high ECMO-volume hospitals ( CONCLUSIONS: High hospital ECMO volume is associated with a lower risk of in-hospital death among patients receiving ECMO after cardiac surgeries, indicating the need for policies that guide patient referrals to institutions with more extensive ECMO experience.