Introduction: Extracorporeal membrane oxygenation (ECMO) is a crucial life-saving intervention in managing severe myocarditis in children. While technological and clinical advancements in ECMO are expanding its indication, comprehensive data on both short-term and long-term outcomes in pediatric myocarditis receiving ECMO remain limited. Objectives: To assess outcomes and complications in pediatric myocarditis patients supported by ECMO. Methods: PubMed, EMBASE, and Cochrane databases were searched for studies reporting outcomes in children with myocarditis receiving ECMO to evaluate in-hospital mortality , heart transplantation, long-term outcomes, and complications. A meta-analysis of proportions using a random-effects model based on the inverse-variance method to pool study estimates with 95% confidence intervals (CI). The Freeman-Tukey double-arcsine transformation was applied to stabilize the variance. Subgroup analyses and meta-regression analyses were performed. Results: This meta-analysis included 29 studies involving 1,022 participants. The pooled inhospital mortality proportion was 25.5% (95% CI, 21.6%–29.7%) in patients receiving ECMO. The pooled estimate of heart transplant was 6.2% (95% CI, 2.4%–11.2%), long-term mortality was 26.8% (95% CI, 17 .7%–36.8%), and progression to dilated cardiomyopathy was 3.8% (95% CI, 0.8%–10.7%). Infection (16.6%; 95% CI, 8.6%–26.1%), renal failure (39.5%; 95% CI, 27 .7%–51.8%) neurologic events (17 .0%; 95% CI, 12.1%–22.3%), and bleeding (26.7%; 95% CI, 20.9%–32.9%) were associated with numerically higher in-hospital mortality , though nonsignificant. Conclusions: ECMO was indicated as a critical resuscitation modality in children with acute myocarditis. Considerable inhospital mortality and complications were observed. Further prospective studies are necessary to guide clinical decision-making for the ECMO strategy in pediatric myocarditis.