Peritoneal malignancies are challenging cancers to treat. Until cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy (CRS & HIPEC) became established treatment of peritoneal malignancies, these patients were commonly palliated. The evolution of CRS & HIPEC as we know it today is the culmination of systematic surgical clearance of the macroscopic disease, combined with microscopic disease treatment through HIPEC. Improved disease understanding has led to realisation of the importance of a systematic approach and completeness of cytoreduction. With the combination of peritoneal stripping and visceral resection, complete cytoreduction is usually able to be accomplished in more than 80% of patients and this highlights the importance of appropriate patient selection. The use of an appropriate HIPEC agent depending on the cancer type and the development of dedicated perfusion machines have allowed the cytotoxic perfusate to be delivered at a consistent temperature, ensuring optimal HIPEC conditions. Popularisation of the technique by Sugarbaker in the 1980s and concurrent demonstration of its safety and efficacy has helped establish the role of CRS & HIPEC in the treatment of peritoneal cancers. Two landmark randomised trials by Verwaal et al [1] and Van driel et al [2] have further confirmed the role of CRS & HIPEC in the treatment of peritoneal cancers of colorectal and ovarian origin respectively. This abstract summarises the timeline in the development of CRS & HIPEC for peritoneal malignancies. References: 1. Verwaal VJ, et al. Randomized trial of CRS & HIPEC vs systemic chemotherapy and palliative surgery in CRC. J Clin Oncol. 2003. 2. Van Driel WJ, et al. HIPEC in Ovarian Cancer. N Engl J Med. 2018.