The current guidelines for resucitation following hypothermia and submersion with cardiac arrest state that rewarming should be continued until a core temperature of 32-34°C is achieved, after which death can be declared if no return of spontaneous circulation has occurred. As no randomized, controlled trials exist, these treatment guidelines are mostly based on a pragmatic approach. Wheater to start or stop resuscitation is notoriusly difficult. Submersion time, water temperature, and prompt resuscitation seem to be crucial factors for outcome. We report a case of successful resuscitation after the use of mechanical chest compressions and extracorporeal circulation in a patient with cardiac arrest due to submersion and accompanying mild hypothermia with a core temperature of 32,2°C caused by submersion.