ABSTRACT Background Peritoneal recurrence challenges pediatric solid tumors. HIPEC is established in adults but pediatric evidence is limited. We assessed safety and preliminary efficacy of intraoperative HIPEC in children. Research design and methods Retrospective study of 100 children (Aug 2020-Jan 2024) undergoing cytoreductive surgery (CRS) plus HIPEC (cisplatin, doxorubicin, or ifosfamide at 40.5–41.5°C for 60 min). Outcomes included complications, recurrence, and survival.