Objective To design a visualized navigational extracorporeal membrane oxygenation（ECMO） prefilling device and evaluate its application effect in the pre-filling training of ICU nurses. Methods A visual navigation ECMO pre-filling device was designed. A quasi-experimental research method was adopted. ICU nurses who participated in the ECMO pre-filling training in a tertiary grade A hospital in Hangzhou were selected as the research subjects. Nurses who participated in the training from July to December 2024 were selected as the experimental group（n=35），and the training was conducted using a visual navigation-type pre-filling device. From January to June 2024，the nurses who participated in the training were the control group（n=30），and the traditional training methods were adopted. The operation practice time，error rate，assessment scores，satisfaction and self-confidence scores of the two groups of nurses were compared. Results The operation practice time of the experimental group[90（45，100） min] was significantly shorter than that of the control group[95（60，120） min]. The operation error rate of the experimental group was 48.2%，which was lower than that of the control group（60.0%）. The operation assessment score was（94.11±1.76） points，which was higher than that of the control group（92.83±1.99） points. The self-confidence score （3.91±0.92） points and the satisfaction score（4.51±0.61） points were both higher than those of the control group（3.40±1.04） points and（4.03±0.77） points，and the differences were statistically significant（P<0.05）. Conclusion The visualized navigation-type ECMO pre-filling device can effectively improve the training efficiency of ICU nurses，enhance their operational experience，and boost their confidence in clinical operations.