【Abstract】Background Being applied with increasing frequency, cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is playing a more and more important role in the therapeutic management of patients with peritoneal surface malignancies（PSM）. Objective This review is aimed to provide anesthesiologists with clinic reference about periaenesthetic management by summarizing the physiopathological changes during CRS-HIPEC. Content CRS-HIPEC is a quite complicated and time-consuming process, with giant abdominal incision, huge fluid loss. The HIPEC phase, characterized by significant physiopathological changes including high hemodynamic status, increased temperature, abnormal blood coagulation, increased peritoneal vascular permeability, arrhythmia and kidney toxicity induced by chemotherapeutic agents, quicker recovery from muscle relaxants and so on, particularly deserves refined perioperative management. Therefore, it is necessary to adopt advanced monitoring methods like PiCCO etc to optimize the therapeutic measures. Trend Due to improved surgical technique and anesthetic management, CRS-HIPEC, an aggressive procedure can be performed with a better prognosis providing a strong interaction between the surgeon and his partner anesthesiologist is warranted.