Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy is a major surgical procedure that is being used increasingly frequently in therapeutic option for selected patients with peritoneal surface malignancies. This is more blood and fluid shift and coagulation changes could be seen in cytoreductive surgery phase. It is applied before hyperthermic intraperitoneal chemotherapy phase and process is longer than hyperthermic intraperitoneal chemotherapy phase. Significant hematologic, hemodynamic and metabolic changes have been seen is in hyperthermic intraperitoneal chemotherapy phase. This surgical procedure is quite a difficult process of anesthetists. The task of anesthesiologist is to know during pathophysiological changes occurring in each phase and accordingly take measures in perioperative. These patients require close monitoring of intraoperative and postoperative period. Primary disease as well as the size of the surgical area, anesthetic administration and the amount of fluid and blood transfusion may affect the outcome. There is a need for further work on this issue. There is no consensus gradually formed on anesthesia despite the increasing frequency. In this article, perioperative anesthetic management are described in cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy.