Peritonitis is still a serious problem in peritoneal dialysis (PD) patients and is associated with mortality. To improve outcomes in PD patients, attention must be focused on preventing peritonitis. This involves attention to training, connection methodologies, PD catheter insertion protocols. To prevent catheter-related peritonitis, the use of gentamicin cream at the exit site for daily routine care is recommended. Other causes of peritonitis include bowel sources, fungal overgrowth often related to prolonged antibiotic care, and peritonitis secondary to procedures. Relapsing peritonitis and refractory exit site infections should be managed by replacing the catheter. Every PD program needs to closely examine every episode to determine the cause, and then undertake an approach to prevent further episodes.