Background There are inequalities in resource allocation and services across peritoneal dialysis (PD) centers in China. This study aimed to explore the association between hospital type (university-affiliated vs. non-university-affiliated hospitals) and clinical outcomes in PD patients. Methods Data from the Peritoneal Dialysis Telemedicine-assisted Platform cohort was analyzed. The primary outcome was all-cause mortality, while secondary outcomes included hemodialysis transfer and first-episode PD-related peritonitis. Univariable and multivariable Fine-Gray models were used to calculate subdistribution hazard ratios (SHRs). Propensity-score matched analyses and sensitivity analyses restricted to incident patients were also performed. Results A total of 7416 PD patients were enrolled (June 2016 to April 2019), with a median follow-up of 29.0 months. University-affiliated hospitals' patients (n = 4806) were younger, had better nutritional status, and higher socio-economic status than those in non-university-affiliated hospitals (n = 2610). University-affiliated hospitals exhibited a lower risk for all-cause mortality (SHR: 0.72, 95% confidence interval (CI): 0.61-0.85, p < 0.001), higher hemodialysis transfer (SHR: 1.31, 95% CI: 1.08-1.60, p < 0.01), but no association with first-episode peritonitis in multivariable analyses. After propensity-score matching, university-affiliated hospitals were still associated with lower all-cause mortality (SHR: 0.74, 95% CI: 0.61-0.91, p < 0.01) and a higher risk of hemodialysis transfer (SHR: 1.52, 95% CI: 1.19-1.94, p < 0.01). Comparable results for all-cause mortality and first-episode peritonitis also found in incident patients. Conclusion In China, PD patients in university-affiliated hospitals had lower mortality but a higher risk of hemodialysis transfer. Further studies are needed to understand these findings and inform future practices and resource allocations.