Purpose Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS+HIPEC) is a radical procedure for patients with peritoneal cancers. Despite the morbid and radical surgery, up to 25% of patients will develop early disease recurrence after curative surgery. For these patients, the surgery is arguably futile. Limited studies had been conducted to identify the predictors of futility in this cohort of patients. The aim of this study is to identify patient and disease characteristics that may lead to early recurrence, perhaps avoid futile surgery and guide clinical decision-making. Method A prospectively maintained electronic database for CRS+HIPEC was reviewed to identify patient, tumour and treatment characteristics that may predict futile surgery. Futile surgery was defined as disease recurrence or death within 12 months of surgery. Patients were classified into futile vs non-futile, and predictors for futility were explored using multivariable regression analysis. Survival was also evaluated between the two groups. Results This study included 197 patients. Using the pre-defined definition for futility, 66 (33.5%) of the patients were deemed futile. Pre-operative Peritoneal Cancer Index (PCI) score is the most predictive factors for predicting futile surgery for CRS+HIPEC (p<0.001). Patients deemed futile had a significantly worse survival than non-futile patients (2-year OS 92% vs 45%, p<0.001) Conclusions The current study highlights the importance of accurate pre-procedural staging in patients planned for CRS+HIPEC. Further studies are warranted to better identify patients at risk of early disease recurrence in order to improve patient selection and long-term oncological outcomes.