The management of peritoneal surface malignancies has changed dramatically. Moving, in less than two decades, from a nihilistic approach offering limited palliation and a short median survival into an aggressive surgical approach combining resection of all tumor deposits (cytoreductive surgery (CRS) combined with hyperthermic intra-peritoneal chemotherapy (HIPEC). This novel approach dramatically changed the outcome of this group of disorders offering a long term survival with curative intent to selected patients. The aim of the current review is to describe, based on current medical literature and our experience, current treatment options with CRS+HIPEC in various peritoneal surface malignancies of gastrointestinal origin, namely, colorectal cancer and appendiceal cancer, indications, technique, and outcomes.