Resolving the most fundamental questions in cosmology requires simulations that match the scale, fidelity, and physical complexity demanded by next-generation sky surveys. To achieve the realism needed for this critical scientific partnership, detailed gas dynamics must be treated self-consistently with gravity for end-to-end modeling of structure formation. Exascale computing enables simulations that span survey-scale volumes while incorporating key astrophysical processes that shape complex cosmic structures. We present results from CRK-HACC, a cosmological hydrodynamics code built for extreme scalability. Using separation-of-scale techniques, GPU-resident tree solvers, in situ analysis pipelines, and multi-tiered I/O, CRK-HACCexecuted Frontier-E: a four trillion particle full-sky simulation, over an order of magnitude larger than previous efforts. The run achieved 513.1 PFLOPs peak performance, processing 46.6 billion particles per second and writing more than 100 PB of data in just over one week of runtime. Frontier-E marks a significant advance in predictive modeling for next-generation cosmological science.