Pseudomyxoma peritonei of appendiceal origin is a disease characterized by the progressive accumulation of mucus ascites within the abdomen and pelvis. Metastatic disease outside the peritoneal cavity is unusual. Gastrointestinal function is lost from external compression of stomach, small bowel, and large bowel. New surgical and regional chemotherapy treatments were used to provide palliation of two patients aged 88 and 85 years. The selection criteria and methodologies for treatment of geriatric patients with pseudomyxoma peritonei are presented.