The proportion of elderly people requiring renal replacement therapy has been increasing in Japan. Although several studies have shown the benefits of peritoneal dialysis (PD) in the elderly, few have reported on outcomes, including prognosis, in elderly PD patients, especially those more than 80 years of age. The purpose of the present study was to evaluate clinical outcomes in elderly (more than 80 years of age) PD patients. We retrospectively evaluated the medical records of elderly PD patients who commenced PD between 2007 and 2011. The frequency of perioperative complications, rate of PD-associated peritonitis, technique survival, overall survival, and utilization of nursing-care insurance systems were investigated as clinical outcomes. The 12 patients eligible for this study (7 men, 5 women; mean age: 85 +/- 3 years) had a median duration of follow-up of 1.2 years (interquartile range: 0.65-1.74 years). Perioperative complications were not observed in any of the patients. The frequency of PD-associated peritonitis was 1 episode in 56 months. During follow-up, 6 patients died, and 3 patients switched to hemodialysis because of tunnel infection or lack of family support. The overall survival rate at 12 months was 83%. Nursing-care insurance was used by 63% of patients. In elderly patients, it is important to predict the potential short-term issues at the initiation of PD to facilitate implementation of social services, such as home-visit nursing-care services, at the time of worsening general condition.