This retrospective study explores the role of echocardiography in assessing pulmonary damage and its correlation with outcomes in ECMO patients with septic shock of pulmonary origin. Among 277 patients screened, 9 had both CT and echocardiography performed. The findings suggest that CT scans were ineffective in differentiating viable lung parenchyma between survivors and non-survivors. However, echocardiography revealed significant differences in pulmonary blood flow (PBF) changes, indicating its potential as a predictive tool for pulmonary recovery in ECMO-treated patients. Specifically, non-survivors experienced a marked decline in PBF, suggesting its utility in prognostication.