Cardiogenic shock can complicate the course of ST-segment elevation myocardial infarction in approximately 10% of cases and is associated with high mortality. In this context, practice guidelines recommend the use of mechanical circulatory support devices based on expert opinion or non-randomized studies. Between 2023 and 2024, three randomized clinical trials using ECMO or Impella have been published. The results of these trials and their potential impact on practice guidelines are discussed in the present review. How to cite this article Giordanino EF. Analysis of the latest clinical trials of mechanical circulatory support in cardiogenic shock and their potential role in modifying practice guidelines. Rev Argent Cardiol 2024;92:298-304. http://dx.doi.org/10.7775/rac.v92.i4.20807