Objective: To analyse the impact of low-intensity anticoagulation on complications in patients undergoing extracorporeal membrane oxygenation. Methods: A retrospective analysis was conducted on the clinical data of 104 patients undergoing extracorporeal membrane oxygenation (ECMO) treatment at our hospital between June 2023 and June 2025. Among these, 45 patients receiving low-intensity anticoagulation were classified into the low-intensity anticoagulation group, while 59 patients receiving high-intensity anticoagulation formed the high-intensity anticoagulation group. The two groups were compared regarding transfusion product usage, coagulation parameters [activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (FIB), D-dimer], liver function [aspartate aminotransferase (AST), alanine aminotransferase (ALT)], and complication incidence. Results: The low-intensity anticoagulation group exhibited significantly lower volumes of red blood cell suspension, plasma, and platelet transfusions compared to the high-intensity anticoagulation group (P < 0.05). The low-intensity anticoagulation group demonstrated shorter APTT and PT times, higher FIB levels, and lower D-dimer levels than the high-intensity anticoagulation group (P < 0.05). Compared with the high-intensity anticoagulation group, the low-intensity anticoagulation group exhibited lower AST and ALT levels (P < 0.05). The incidence of complications was lower in the low-intensity anticoagulation group than in the high-intensity anticoagulation group (P < 0.05). Conclusion:? Low-intensity anticoagulation yields more favourable outcomes in patients undergoing extracorporeal membrane oxygenation, with fewer complications and enhanced safety.