Dialysate leakage is one of the major non-infectious complications of peritoneal dialysis. Late leakage is defined as occurring more than 30 days after catheter placement and may present as subcutaneous edema, genital edema, or hernia. Treatment options include surgical repair, temporary conversion to hemodialysis, and reduction of dialysate volume. Previous literature generally recommends early surgical repair when conservative measures fail, in order to reduce complications; however, the postoperative recurrence rate is high. Some patients are unable to undergo surgery or transition to hemodialysis due to underlying comorbidities or personal preference, making management challenging. This article reports three cases of late dialysate leakage from the Peritoneal Dialysis Center of Zhongnan Hospital of Wuhan University, presenting as scrotal edema, subcutaneous leakage, and inguinal hernia, respectively. All three patients were managed with low‑volume nocturnal automated peritoneal dialysis (APD) to continue peritoneal dialysis. The leakage resolved within 2～3 months, and they were gradually transitioned back to continuous ambulatory peritoneal dialysis (CAPD), successfully avoiding conversion to hemodialysis. After more than 5 years of follow-up, no recurrence of leakage occurred in any of the three patients. Therefore, low-volume nocturnal APD represents an effective alternative treatment option for patients with late dialysate leakage who are intolerant to surgery or unable to switch to hemodialysis.