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Peritoneal metastasis (PM) is a common manifestation of advanced solid tumors such as colorectal cancer and gastric cancer. Traditional systemic chemotherapy has limited efficacy due to the blood-peritoneal barrier. With the development of local treatment technologies, the therapeutic model has shifted to "systemic+local" combined therapy. This article systematically summarizes mainstream local treatment options, including core technologies such as cytoreductive surgery (CRS), hyperthermic intraperitoneal chemotherapy (HIPEC), and pressurized intraperitoneal aerosol chemotherapy (PIPAC), as well as the operational standards, indications, and clinical evidence of combined strategies like CRS+HIPEC. Meanwhile, it analyzes the differences in individualized treatment pathways for PM derived from different tumors. Studies have shown that CRS+HIPEC, as the core curative scheme, can significantly prolong the survival of some patients; minimally invasive technologies such as PIPAC and normothermic intraperitoneal chemotherapy (NIPEC) provide new options for patients intolerant to major surgery; the combination of targeted therapy, immunotherapy, and local treatment shows synergistic potential. Currently, this field still faces challenges such as unbalanced evidence levels and inconsistent selection criteria. In the future, efforts should focus on precision, minimally invasive, and individualized development, optimizing treatment strategies through multi-omics technologies and evidence-based research to improve patient prognosis.