Objective To explore the efficacy and safety of hyperthermic intraperitoneal chemotherapy(HIPEC)for patients with gastrointestinal malignant tumors.Methods A retrospective analysis was conduc-ted on the clinical data of 319 patients with malignant tumors admitted to the Gastroenterology Department of the Second Xiangya Hospital of Central South University and Shimen County People's Hospital from January 2021 to January 2023.189 cases received HIPEC treatment(the HIPEC group,including 111 cases of the HIPEC+in-travenous chemotherapy group and 78 cases of the simple HIPEC group),100 cases received intravenous chem-otherapy(the intravenous chemotherapy group),and 30 cases received palliative treatment(the palliative treat-ment group).The survival status of patients was followed up and analysis of influencing factors were conducted.Results Extensive metastasis and dissemination of tumors were observed in 319 patients before and during surgery.In situ tumors were completely removed in 162 patients,and postoperative complications occurred in 36 patients.The median survival time of the HIPEC group was 17.0 months,while the intravenous chemothera-py group and the palliative treatment group was 11.9 months and 5.6 months,respectively.There was no sig-nificant correlation(P>0.05)between the patients'prognosis and gender,age,BMI,tumor size,complica-tions,length of hospital stay,complicated disease,ascites,previous surgical history,or other chemotherapy regimens.The degree of cell differentiation,the presence of liver,lung,and distant bone metastasis,and the in situ tumor resection was significantly correlated with prognosis(P<0.05).Conclusions In patients with end-stage gastrointestinal tumors,HIPEC can significantly improve median survival time,and patients without liver,lung,or bone metastasis or the highly differentiated and mediumly to highly differentiated tumor cell groups can benefit from it.HIPEC after in situ tumor resection can prolong the survival time.