Unresectable colorectal liver metastases are often the cause of patient mortality in the setting of metastatic colorectal cancer. Early lines (first and second) of systemic therapy are generally comprised of chemotherapy with or without targeted biologics. In the absence of druggable targets and clinical trials, third and subsequent lines of therapy have limited efficacy with marginal improvements in survival. In liver-dominant disease, the option of utilizing hepatic artery infusion (HAI) pump chemotherapy exists. In this chapter we will review the role of HAI in this patient population.