Gastric cancer (GC) is the fifth most diagnosed cancer, but it is the third leading cause of cancer death worldwide. Despite the likelihood of gastric cancer metastasizing to the peritoneum, optimal management strategies for this population remain undefined. We carried out a retrospective analysis to present our findings on patients with advanced gastric cancer (AGC) with peritoneal metastases (CP) who underwent neoadjuvant chemotherapy followed by gastrectomy + hyperthermic intraperitoneal chemotherapy (HIPEC). To better understand the data, we compared these patients with AGC patients without CP who were treated with neoadjuvant chemotherapy and surgery, as well as with another group of patients who underwent upfront surgery. Patients who undergo surgery and HIPEC achieve a higher survival rate than patients in the literature who undergo only palliative chemotherapy with a median overall survival of 28 months with a low incidence of major complications.