Introduction Cytoreductive surgery with hyperthermic intra-peritoneal chemotherapy (CRS+HIPEC) is a radical procedure that may offer cure in selected patients with peritoneal malignancy. Interest in CRS+HIPEC has grown as evidence surrounding its efficacy continues to build. To help overcome learning curves, new centres are commonly mentored by experienced surgeons from established centres. The purpose of this study is to review the experience of a CRS+HIPEC service at an Australian referral centre. Methods Consecutive patients planned for CRS+HIPEC from program inception in April 2017 to 2023 were retrospectively reviewed. All patients are prospectively recruited for a clinical and quality of life study. Patient demographics are tabulated. Categorical data was compared using X2 and continuous data compared using t-test. Results Over the study period, 448 procedures were performed on 423 patients. There were 239 females (56.5%). Median age at time of surgery was 56.0 (IQR 44.0-65.0). Indications for surgery were colorectal peritoneal metastases (194, 45.9%), high and low grade appendix tumours (94 (22.2%) and 67 (15.8%) respectively), ovarian cancers (30, 7.1%) and other cancer types. The 30-day mortality was 1.1%. For the primary CRS+HIPEC cohort, the median PCI was 12 (IQR 6-23). Complete cytoreduction was achieved in 183 (94.3%) patients with colorectal peritoneal metastases and 143 (88.9%) patients with appendiceal tumours. More complex procedures were undertaken as experience increased, including repeat CRS+HIPEC procedures from 2019 and laparoscopic assisted CRS+HIPEC procedures in 2023. Conclusion CRS+HIPEC can be offered safely with good outcomes in appropriately supported centres.