Interest in intraperitoneal (IP)-based therapies for epithelial ovarian cancer (EOC) has grown over the past decade. Yet despite multiple theoretical and clinical advantages, IP therapy has not been widely adopted in the U.S. Recently, support for hyperthermic intraperitoneal chemotherapy (HIPEC) has increased. There have been numerous retrospective studies and meta-analyses that support the use of HIPEC in ovarian cancer [1–5]. Further optimism for HIPEC was based on the recent results of a phase III trial [5–9], but significant criticisms have been noted over the use of HIPEC [10–13].