Abstract: Peritoneal dialysis (PD) is a crucial renal replacement therapy for end‑stage renal disease (ESRD), offering significant advantages as high flexibility, hemodynamic stability, and high cost‑effectiveness. However, prolonged exposure to intra‑abdominal dialysate may predispose to the mechanical complication of abdominal external hernia. Abdominal external hernia may lead to various adverse clinical outcomes. In severe cases, it can progress to incarceration or even rupture, ultimately necessitating discontinuation of the therapy. The authors systematically review PD-associated abdominal external hernias, including their clinical landscape, risk factors, surgical treatment strategies and prognostic determinants. They also assess the effects of hernia repair on residual renal function, aiming to provide references for clinical decision‑making.