Over the last decades, there has been a paradigm shift regarding the management of peritoneal dissemination of intra-abdominal malignancies. Previously believed to be an end-stage disease amenable only to palliative management, several studies have reported achieving significant survival advantage by applying cytoreduction of the tumour load with or without intraoperative hyperthermic intraperitoneal chemotherapy administration. It is hard to classify this procedure as curative despite the reported good results in achieving a reasonable 5-years survival. However, its ability to control the disease process is clearly recognized in different types of intra-abdominal malignancies and its role is better understood within the new concept of treating advanced cancer as a chronic disease. The aim of this review is to discuss the concept, techniques, results and complications of this approach. Current indications and future directions will also be emphasized.