Adult respiratory distress syndrome (ARDS) remains a great challenge for physicians in intensive care units with high mortality rates. Although protective lung ventilation is the mainstay of ARDS therapy, it may lead to intractable hypercapnia. Pumpless extracorporeal lung-assist was suggested as an invasive alternative to conventional treatment when gas exchange is not optimized with rigorous mechanical ventilation alone. Here, we report the treatment of a patient with extracorporeal lung-asist in the course of pneumonia-related ARDS due to intractable hypercapnia as a result of failure of protective ventilation strategy and her outcome after treatment. Interventional Lung Assist device (iLA) contains a specially designed low resistance lung membrane, which uses the pressure difference between the arterial and venous circulation. This system enables the use of high airway pressures for oxygenation in combination with very low tidal volumes to avoid ventilator-induced lung injury and this gives time to patient for lung recovery.