〔Abstract〕 Objective To investigate the difference of treatment effect and survival between peritoneal dialysis and hemodialysis in end-stage diabetic nephropathy. Methods A total of 58 patients with end-stage diabetic nephropathy admitted to Dongguan Kanghua Hospital from January 2017 to January 2018 were selected. According to the difference of treatment methods, the hemodialysis group (35 cases) received hemodialysis treatment, peritoneal dialysis group (23 cases) received peritoneal dialysis treatment. The differences of treatment effect and survival time between the two groups were compared, and the renal function indexes before and after treatment were compared. Results The total therapeutic effect of peritoneal dialysis group was 91.30%, which was significantly higher than that of hemodialysis group (74.29%), the difference was statistically significant (P < 0.05). The survival time of patients in peritoneal dialysis group was (33.16 ± 1.21) months, significantly longer than that in hemodialysis group (28.11 ± 1.43) months, the difference was statistically significant (P < 0.05). After treatment, the renal function index of the peritoneal dialysis group was better than that of the hemodialysis group, the difference was statistically significant (P < 0.05). Conclusion Peritoneal dialysis is better than hemodialysis in the treatment of end-stage diabetic nephropathy, which can improve renal function and prolong the survival of patients.