Abstract: Peritoneal dialysis⁃associated peritonitis (PDAP) remains the leading complication contributing to technical failure and mortality in patients undergoing peritoneal dialysis (PD).PD patients commonly exhibit significant gut microbiota dysbiosis,characterized by reduced microbial diversity,depletion of beneficial taxa,and enrichment of potential pathogens.Such dysbiosis promotes a susceptible state for PDAP by compromising intestinal barrier integrity,facilitating intestinal bacterial and endotoxin translocation,and driving systemic immunometabolic dysregulation.This review aims to systematically elucidate the pivotal role of gut microbiota dysbiosis in initiating and exacerbating PDAP,provide an in⁃depth analysis of the underlying molecular mechanisms,and discuss potential therapeutic strategies targeting the gut microbial ecosystem.