Objectives: Urgent-start peritoneal dialysis (USPD) has been identified as the efficient approach to initiate renal replacement treatment in end-stage renal disease patients. Cardiovascular mortality of urgent dialysis is an important issue. Methods: We carried out the present multicenter retrospective cohort study in five centers from Northeast China, including the A, B, C, D and E hospital. We enrolled adults initiating PD between January 1st, 2013 and 31st, December 2019, and excluded those who had insufficient records, or initiated PD after 2 weeks following catheter insertion. The enrolled patients were followed up till the occurrence of one or more events below: technical failure, death, loss-to-follow-up, and renal transplantation. Results: There were altogether 1549 cases enrolled into this work.，and 123 encountered cardiovascular death. Upon multivariate regression, predictors of cardiovascular death included advanced age (HR 1.045, 95% CI [1.031, 1.060]; p<0.001), higher eGFR (HR 1.084, 95% CI [1.052, 1.117]; p=0.001), combined with DM (HR 1.471, 95% CI [1.026, 2.110]; p=0.036), and advanced HF stage (class III versus class 0-I, HR 5.262; 95% CI [3.281, 8.437]; p<0.001; class IV versus class 0-I, HR 6.409; 95% CI [4.145, 9.912]; p<0.001). In addition, the predictors of cardiovascular death in diabetic USPD patients included advanced age (HR 1.052, 95% CI [1.027, 1.078]; p<0.001) and advanced HF stages (class III versus class 0-I, HR 7.843; 95% CI [4.249, 14.476]; p<0.001; class IV versus class 0-I, HR 5.285; 95% CI [2.880, 9.698]; p<0.001). The predictors of cardiovascular death in elderly USPD patients were advanced age (HR 1.045, 95% CI [1.016, 1.075]; p<0.001) and advanced HF stages (class III versus class 0-I, HR 3.407; 95% CI [1.911, 6.073]; p<0.001; class IV versus class 0-I, HR 5.039; 95% CI [2.982, 8.516]; p<0.001). Conclusion: Risk factors related to cardiovascular death included advanced age, higher eGFR, combined with diabetes, and advanced heart failure stages among USPD patients.