Introduction <p>Anesthesiologist and surgeon experience are associated with improved outcomes and lower costs in various oncologic procedures. The role of the anesthesiologist-surgeon dyad on outcomes and charges for cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) has not been studied.</p> Methods <p>We performed a retrospective cohort study of patients undergoing CRS-HIPEC at a single quaternary center from 2016 to 2023. High-volume anesthesiologists (ANES) and surgeons (SURG) were defined as those in the top quartile of cases for their respective position (ANES: 10 cases, SURG: 87 cases). The study cohort was then divided into four subcohorts based on anesthesiologist and surgeon volume: low-volume anesthesiologist and surgeon (LALS), high-volume anesthesiologist and low-volume surgeon (HALS), low-volume anesthesiologist and high-volume surgeon (LAHS), and high-volume anesthesiologist and surgeon (HAHS).</p> Results <p>The study cohort consisted of 237 patients undergoing CRS-HIPEC from 2016 to 2023. Median age was 59 years (interquartile range 48–66). Most patients were female (n = 135, 57%), White (n = 174, 73%), and privately insured (n = 134, 57%). The HAHS cohort had the lowest median total ($99,921, <i>p</i> = 0.603), operating room ($33,560, <i>p</i> = 0.266), and other ($11,384, <i>p</i> = 0.437) charges compared with the other cohorts. After adjusting for patient complexity, the HAHS cohort had significantly lower operating room charges (estimate −$5784, 95% confidence interval [−$11,076 to −$491], <i>p</i> = 0.032), length of stay (− 4.77 days, [− 9.04 to − 0.51 days], <i>p</i> = 0.029), and odds of delayed extubation (odds ratio 0.79, 95% confidence interval [0.65–0.98], <i>p</i> = 0.029) compared with the LALS cohort.</p> Conclusions <p>The HAHS teams are associated with significantly lower operating room charges, length of stay, and delayed extubation compared with LALS teams in CRS-HIPEC.</p>