Objective To retrospectively analyze the occurrence and clinical outcomes of peritoneal dialysis‑associated peritonitis (PDAP) at the largest peritoneal dialysis (PD) center in Xizang, and to provide evidence for improving the prevention and management of PDAP in this region. Methods Clinical data of patients with PDAP treated at the People's Hospital of Xizang Autonomous Region from October 2013 to July 2021 were collected. Patients were divided into a continued‑PD group and a PD‑withdrawal group based on final clinical outcomes. Clinical characteristics were analyzed, and factors influencing PDAP outcomes were explored. Results During the study period, 78 patients experienced 142 episodes of PDAP. The mean age at the time of peritonitis was (46.5±14.7) years, with a median dialysis vintage of 15 (6, 30) months. Non‑standard operation was identified in 49 episodes (34.5%), representing one of the leading causes of PDAP. Pathogenic culture of PD effluent was performed in 119 episodes (83.8%), among which 38 episodes (31.9%) were positive for Staphylococcus epidermidis, and 58 episodes (48.7%) yielded negative culture results. Regarding final outcomes among the 78 patients, 55 continued PD and 23 withdrew from PD. Compared with the continued‑PD group, the PD‑withdrawal group had a significantly higher proportion of patients who experienced three or more PDAP episodes (χ²=7.831, P=0.020), lower serum albumin levels (t=‑2.361, P=0.021), and higher effluent white blood cell counts on day 5 (Z=‑2.379, P=0.015). Multivariate logistic regression showed that three or more PDAP episodes was an independent risk factor for PD withdrawal (OR=5.155, 95% CI: 1.351～19.677, P=0.016), while higher serum albumin was a protective factor (OR=0.875, 95% CI: 0.777～0.987, P=0.029).  Conclusion Staphylococcal epidermidis infections due to improper procedures are prominent causes of PDAP in Xizang. Recurrent PDAP and hypoalbuminemia are independent risk factors for PD withdrawal. Strengthening training and re-education for PD patients in Xizang, along with improving nutritional status, may help reduce PDAP incidence and subsequent technique failure.