Ten per cent of patients with colorectal cancer will develop peritoneal metastases. These metastases are known to have a lesser response to systemic chemotherapy than liver- and lung metastases. Randomized studies have shown that adding cytoreductive surgery and heated intraperitoneal chemotherapy (HIPEC) to this treatment gives a better chance of survival. Recently, a randomized study failed to show a difference in survival between cytoreductive surgery plus HIPEC versus cytoreductive surgery alone. These facts are summarized in this review.