Cardiac arrest in the Catheterization Lab is a rare and unique scenario that is often logistically challenging. It often has dire prognosis especially in patients suffering from severe pre-existing illnesses (high risk patient) such as acute myocardial infarction with cardiogenic shock, or patients undergoing high risk procedures. As the number of complex interventional procedures increases, cardiac arrest in the cath lab will become more common and optimal management of this scenario is critical for both the patient and operator.In this review, we will discuss the special challenges during the resuscitation efforts in cath lab, especially with tradition chest compression. We will discuss the alternative options including mechanical compression devices and Invasive Percutaneous Mechanical Circulatory Support Devices. Finally, we will offer management suggestions on selecting the appropriate circulatory support device based on clinical and anatomic risks.