Objective：The purpose of this study is to retrospectively observe the clinical efficacy and adverse reactions of docetaxel hyperthermic intraperitoneal chemotherapy (HIPEC) combined with endostar in treatment of malignant ascites. Methods：56 cases of malignant ascites admitted to Zhejiang Hospital from July 2019 and October 2020 had received no less than second-line chemotherapy. The observation group (n = 29) was treated with endostar 60mg d1,4,7 Q3W intraperitoneal injection combined with docetaxel 60mg/m2 d4 HIPEC Q3W for 2 cycles. The control group (n = 27) was just treated with docetaxel 60mg/m2 d1 HIPEC Q3W for 2 cycles. The general clinical data and qualitative data of the treatment results were processed by SPSS26.0 using χ2 test, and quantitative data were processed by t test. When P < 0.05, statistical data can be considered statistically significant.Results：There were significant differences between the observation group and the control group in objective response rate (ORR) (65.5% vs 37.0%，P=0.033)，in the improvement rate of KPS (48.3% vs 22.2%, P=0.042)，also in the median control time (57dvs 45d，P=0.027). The incidence of III to IV adverse reactions was low, and no treatment-related death was observed. There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion：Endostar combined with docetaxel HIPEC has good clinical effect on malignant ascites and can improve patients’ quality of life, and the adverse reactions can be tolerated.