Use of hyperthermic intra-peritoneal chemotherapy (HIPEC) in children has only been used more widely in recent years. It was first described in the treatment of desmoplastic small round cell tumor (DSRCT), a rare cancer spreading across peritoneal surfaces. Outcomes in DSRCT were improved in those with no extraperitoneal disease and only after complete or near complete cytoreduction. Determining which other cancers could be treated with HIPEC has been the focus of much study. Additional types of cancers have been treated using HIPEC with varying degrees of improved outcomes including colorectal cancer, ovarian cancer, rhabdomyosarcoma, non-rhabdomyosarcoma, and solid tumors with peritoneal carcinomatosis. Many of these studies have been small and additional studies are required. With the current data available, improved outcomes have been seen most consistently in DSRCT, ovarian cancer, rhabdomyosarcoma, and solid tumors with peritoneal carcinomatosis. Given the extensive surgery, prolonged recovery and potential complications, use of HIPEC should be done with great care and consideration such that only those patients with expected improvement in outcomes are offered this therapy.