Aim To study the efficacy and safety of extra-corporeal membrane oxygenation (ECMO) combined with intra-aortic balloon pump (IABP) in the treatment of refractory cardiogenic shock (RCS). Methods 96 patients with RCS were divided into 3 groups:IABP group (n＝34), ECMO group (n＝32) and IABP＋ECMO combination group (n＝30). On the basis of conventional antishock drugs, IABP, ECMO and IABP＋ECMO were used respectively to support the treatment. Changes of heart rate, mean arterial pressure (MAP), central venous pressure (CVP), oxygen saturation (SO₂), arterial lactate, cardiac troponin I (cTnI), brain natriuretic peptide (BNP), left ventricular end-diastolic diameter (LVED), left ventricular ejection fraction (LVEF), and vasoactive drugs (dobutamine, norepinephrine) dosage, complications and clinical outcomes (weaning success rate and in-hospital mortality) were compared among three groups before treatment and 6 hours, 1 day, 2 days, 3 days after treatment. Results After 3 days of treatment, the above indexes were improved gradually in all the three groups, and the above indexes in the combination group were significantly better than those in the IABP group and the ECMO group (P＜0.05 or P＜0.01). The improvements of heart rate, MAP, CVP, SO₂, arterial lactate, cTnI, LVEF, dobutamine and norepinephrine dosage in ECMO group were better than those in IABP group (all P＜0.01). The improvements of BNP and LVED in IABP group were better than those in ECMO group (P＜0.05, P＜0.01). The incidence of complications in combination group was higher than that in IABP group and ECMO group (χ²＝15.875, P＜0.001; χ²＝4.504, P＝0.034); The incidence of complications in ECMO group was higher than that in IABP group (χ²＝3.957, P＝0.047). The weaning success rate in combination group was higher than that in IABP group and ECMO group (χ²＝16.063, P＜0.001; χ²＝5.792, P＝0.016). There was no significant difference in the in-hospital mortality among the three groups (P＞0.05). Conclusion IABP＋ECMO combined therapy is superior to IABP and ECMO in improving hemodynamics in patients with RCS, but combined therapy increases the incidence of complications, decreases the improvement of clinical prognosis; Reducing complications is the key to improve the efficacy of combined therapy.