This study analyzes venoarterial extracorporeal membrane oxygenation (VA-ECMO) use after infective endocarditis (IE) surgery using Netherlands Heart Registration data (2013–2022). Among 3,468 cases, 1.4% required VA-ECMO, with 49% in-hospital mortality and 60.9% one-year mortality. Despite increased risk factors and complications, VA-ECMO outcomes were comparable to non-IE postcardiotomy VA-ECMO cases, challenging the exclusion of IE patients based on high anticipated mortality.