The initiation of a Program in Peritoneal Malignancy is a long and complex process. The novelty, technically demanding nature and steep learning curve that characterize this treatment strategy calls for a carefully planned, systematic, controlled, and informed introduction is an institution, for which an Institutional Review Board approved protocol is suggested. Commitment of a surgical team and institution, education of other physician, nurses, and ancillary personnel involved in the procedure, safety precaution for patients and health care workers, and proper patient selection are important requirements for initiating the program. This manuscript provides a guide for implementation of this treatment strategy with a minimum of untoward events, reduced apprehension of medical and nursing colleagues, and a maximum benefit for patients.