Findings demonstrate a poor prognosis in patients with fulminant myocarditis who underwent veno‐arterial extracorporeal membrane oxygenation. In some cases, especially of eosinophilic myocarditis, long‐term cardiac function was found to be impaired.

• In this multicenter retrospective analysis, 216 patients with fulminant myocarditis needing percutaneous mechanical circulatory support were included: 61 treated with intra‐aortic balloon pump or Impella alone, and 155 had veno‐arterial extracorporeal membrane oxygenation and were treated with or without intra‐aortic balloon pump or Impella.

• Histologically, 107 patients were found to have lymphocytic myocarditis; 34, eosinophilic myocarditis; and 4, giant cell myocarditis.

• At 90 days, 1 year, and 6 years, freedom from composite endpoint (death, durable left ventricular assist device implantation, and heart transplantation) was estimated to be 66%, 62%, and 57%, respectively.

• In the multivariable analysis, poor prognosis was evident in relation to veno‐arterial extracorporeal membrane oxygenation use (hazard ratio [HR], 5.27).

• Better prognosis (HR, 0.28) was seen in the eosinophilic myocarditis subgroup vs lymphocytic myocarditis subgroup but not in the multivariable analysis.

• Factors that were also associated with poor prognosis were: ventricular tachycardia/ventricular fibrillation rhythm at admission, high C‐reactive protein level, and no endomyocardial biopsy.