There are several perioperative considerations for hepatic artery infusion pump (HAIP) placement. Preoperatively, patients should be assessed for normal liver function and no evidence of significant extrahepatic malignancy. Timing of HAIP placement can be variable depending on the extent of disease and prior therapy. For patients with colorectal liver metastases, primary tumor resection can be performed simultaneously with no increased risk of postoperative complications. For unresectable liver disease, HAIP placement will occur prior to primary resection; for resectable disease, HAIP placement can occur at the time of initial resection, and may be followed by a second operation, i.e., a two-staged hepatectomy approach. Postoperatively, hepatic perfusion should be assessed via a nuclear medicine scan, and patients should be closely monitored for pump pocket complications.