Background Treatment for peritoneal malignancy (PM) can include cytoreductive surgery (CRS) and heated intrapertioneal chemotherapy (HIPEC) and is associated with morbidity and mortality. Physical, psychological and nutritional outcomes are important pre-operatively. The aim of this pilot study was to investigate these outcomes in patients with PM before and after CRS-HIPEC. Methods Between June2018andNovember2019,participants were recruited to a single-centre study. Primary outcome was cardiopulmonary exercise testing (CPET) variables oxygen uptake (VO 2 ) at anaerobic threshold (AT) and at peak. Secondary outcome measures were upper and lower body strength, health related quality of life (HRQoL) and the surgical fear questionnaire. Exploratory outcomes included body mass index, nutrient intake and postoperative outcome. All participants were asked to undertake assessments pre CRS-HIPEC and12weeksfollowing the procedure. Results Thirty-nine patients were screened, 38 were eligible and 16 were recruited. Ten female and 6 male, median (IQR) age 53(42–63) years. Of the 16 patients recruited, 14 proceeded with CRS-HIPECand10competedthefollowupassessment atweek12.Pre-operative VO 2 at ATandpeakwas16.8(13.7–18) ml.kg , upper body strength was 25.9 (20.3–41.5) kg, lower body strength was 14 (10.4–20.3) sec, HRQoL(overall health status) was 72.5 (46.3–80) % whilst overall surgical fear was 39 (30.5–51). The VO 2 at AT decreased significantly (p = 0.05) and HRQoL improved (p = 0.04) between pre and post- CRS-HIPEC. There were no significant differences for any of the other outcome measures. Conclusion This pilot study showed a significant decrease in VO 2 at AT and an improvement in overall HRQoLatthe12weekfollowup.Thefindings will inform a larger study design to investigate a prehabilitation and rehabilitation cancer survivorship programme.