AIM: This research aimed to evaluate the long-term survival rates and relapse-free status of colorectal cancer (CRC) patients with peritoneal metastases who underwent cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC). The data are expected to provide valuable insights for determining therapeutic options for these patients. METHODS: PubMed (MEDLINE), Embase, Web of Science, Cochrane, Ovid, Scopus, and ClinicalTrials.gov databases were searched from inception to 1 August 2023, without language restrictions. The primary outcomes of interest were overall survival (OS) and relapse-free survival/disease-free survival (RFS/DFS), while the secondary outcome was complications. Fourteen studies were included in both qualitative and quantitative analyses. RESULTS: Analyses of the 14 included publications (10 cohort studies and 4 randomized controlled trials) indicated significantly higher OS and RFS/DFS rates in the CRS + HIPEC group compared to the control group regimens. CONCLUSIONS: Individuals with peritoneal metastases following a diagnosis of CRC may have improved survival outcomes when treated with CRS + HIPEC. SYSTEMATIC REVIEW REGISTRATION: PROSPERO: CRD42023470622.