A 63-year-old man presenting with fever was admitted to our hospital with a diagnosis of pneumonia. However, his respiratory condition worsened after admission, and he was intubated and put on mechanical ventilation. His condition was further complicated by a right-sided pneumothorax identified on the day following intubation. Three chest tubes were inserted through the intercostal spaces; however, the pneumothorax did not resolve, and the hypoxemia worsened. The patient was then placed on extracorporeal membrane oxygenation (ECMO), following which the hypoxemia improved. However, the pneumothorax did not improve, despite repeated pleurodesis. We then performed an ECMO-assisted bullectomy. After the operation, the patient was weaned from ECMO and mechanical ventilation. This case indicates that ECMO is an effective way to support patients diagnosed with severe hypoxemia along with intractable pneumothorax who fail to respond to conventional ventilation strategies.