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Extracorporeal membrane oxygenation (ECMO) is a temporary cardiopulmonary support for neonates and children with potentially reversible cardiopulmonary disorders. Patients requiring ECMO support are at risk for brain injury due to pre-ECMO medical conditions, ECMO cannula placement in the carotid artery and internal jugular vessels, and complications arising during ECMO. Acute brain injury may result in acute symptomatic seizures. Clinical and electrographic seizures are common in neonates and children undergoing ECMO. At the same time, the majority of seizures during ECMO are subclinical, and can only be diagnosed through continuous EEG monitoring. Thus, recent consensus statements have recommended increasing use of continuous EEG monitoring (cEEG) during ECMO in neonates and children. This chapter reviews the available data regarding seizure incidence, risk factors, and outcomes in neonates and children requiring ECMO support.