Regional liver-directed chemotherapy can be delivered through an implantable hepatic artery infusion pump, placed either with an open approach or with minimally invasive surgery. This regional chemotherapy can be used in the management of colorectal liver metastases as either adjuvant therapy after complete resection, conversion therapy in unresectable disease, or palliative therapy in liver-dominant disease. Placement of this pump requires meticulous vascular dissections of the hepatic arteries and the gastroduodenal artery, where the catheter is most commonly situated. As such, this procedure should be performed by experienced surgeons familiar with its technical requirements and complications, in collaboration with medical oncologist familiar with its indications and side effects.