In the era of implantable ventricular assist device (VAD), the role of extracorporeal VAD is changing. The extracorporeal VAD was ever the mainstream of treatment for severe heart failure. Now, it is mainly applied to patients with severe cardiogenic shock. Recently the centrifugal pump available for cardiopulmonary bypass system has been often used as the extracorporeal VAD because of its simplicity of management. Although the implantable VAD plays the pivotal role for bridge to transplantation since its clinical introduction in 2011, the extracorporeal VAD still has the important role for end-stage heart failure and cardiogenic shock. We have experienced 47 cases of the extracorporeal VAD until now. Here, based on our experience, we describe the "past and present" role of the extracorporeal VAD and mention the future aspect of the extracorporeal VAD.