Objectives: Peritoneal dialysis (PD) patients exhibiting a heightened peritoneal membrane transport status tend to endure less favorable clinical outcomes in comparison to their counterparts with a lower peritoneal transport status. This study aims to ascertain the interrelation between peritoneal membrane transport status and chosen PD modality concerning the clinical outcomes of recently initiated PD patients. Methods: A retrospective cohort analysis was conducted, encompassing 359 incident PD patients enrolled between 2016 and 2020, with a follow-up period extending until December 2022. Patients were categorized based on their initial peritoneal membrane transport status and their selected PD modality. Clinical parameters, encompassing age, gender, and demographics, were meticulously documented. Cox regression models were employed for the primary outcomes analysis, which encompassed mortality, technique failure and peritonitis. Results: All incident PD patients were divided into four groups: 72 patients in the H-HA_APD group, 93 patients in the H-HA_CAPD group, 63 patients in the L-LA_APD group, and 131 patients in the L-LA_CAPD group. The L-LA_APD group had a statistically lower rate of peritonitis compared to the H-HA group (24% vs. 42%, p < 0.041), while both groups had the same drop-out rate (32% vs. 32%). Multivariate analysis revealed that age and CRP were independent factors affecting technique failure and mortality rates. Age was predictors of the time to the first occurrence of peritonitis. Conclusions: Individuals characterized by a high peritoneal membrane transport status experienced notably elevated mortality and peritonitis rates. However, it is imperative to underscore that age, rather than the initial peritoneal membrane transport status, could emerge as the pivotal predictive factor influencing the clinical outcomes of newly initiated PD patients.