Objectives: We investigated the short- and long-term survival rate, technical failure-free survival rate, and peritonitis-free survival rate after immediate-start peritoneal dialysis (PD), and the risk factors associated with these outcomes. Methods: A retrospective analysis were done with 134 patients who had percutaneous peritoneal dialysis catheter implantation and started PD without break-in period between August 1st, 2005 and November 30th, 2021 at Konkuk University Medical Center. The primary outcome was patient survival rate and the secondary outcome was technical-free survival rate and peritonitis-free survival rate. Technical failure was defined as transfer from PD to HD and maintaining HD thereafter for more than 30 days. Peritonitis free survival was defined as time to first episode of peritonitis. Kaplan-Meier analysis and multivariable cause-specific hazards models was used for analysis. Results: Mean follow-up period was 4.08(1.39-5.79) years. The mean age was 62.1±13.6 years, and 84 patients(62.2%) were male, 86 patients(63.7%) had diabetes mellitus (DM). 71 patients (52.6%) had at least one incidence of peritonitis while maintaining peritoneal dialysis. The patient survival rate of 1, 3, 5, 10-year were 96.3%, 84.5%, 74.7%, and 45.1%, respectively. The technical-freesurvival rate of 1, 3, 5, 10-year were 87.6%, 75.9%, 64.7%, and 47.6, respectively. The peritonitis-free survival rate of 1, 3, 5, 10-yearwere 92%, 73.6%, 56.1%, and 25.0, respectively. In univariate analysis, DM was associated with patient survival, and DM and cardiovascular disease was associated with technical failure. In multivariable analysis, DM was the only factor associated with patient survival and technical failure.No factors were associated with peritonitis-free survival. Conclusions: Percutaneous peritoneal catheter implantation method using guidewire enable us to start PD without break-in period. DM increased mortality and technical failure in immediate-start PD patients.