Objective To investigate the characteristics of conventional ultrasound and shear wave elastography images of the abdomen of patients on long-term peritoneal dialysis and their feasibility in assessing the severity of peritoneal sclerosis. Methods Patients with Continuous ambulatory peritoneal dialysis (CAPD) with different duration of peritoneal dialysis were examined by ordinary ultrasound and elastic ultrasound respectively. The intestinal wall thickness, intestinal wall calcification, peritoneal calcification, degree of encapsulated ascites, intestinal dilatation and other common ultrasound indicators were observed. Each common ultrasound index was quantified as ultrasound performance score, and the elasticity of intestinal wall and peritoneum was measured. To analyze and verify the relationship between ultrasound comprehensive performance score, elasticity index and the severity of peritoneal sclerosis. Results Patients on continuous ambulatory peritoneal dialysis were divided into three groups according to different duration of abdominal dialysis: ≤3 years (n=71), 4-10 years (n=78), and ≥11 years (n=19). Patients with abdominal dialysis under conventional ultrasound had characteristic ultrasound manifestations with increasing dialysis duration: thickened intestinal wall, intestinal wall calcification, thickened peritoneum, peritoneal calcification, and encapsulated ascites. The thickened intestinal wall, intestinal wall calcification, and peritoneal calcification mainly occurred around the end of the peritoneal dialysis tubing. The combined ultrasound performance scores were 0 (0, 0), 1 (0, 2), 2 (0, 3), the intestinal wall elasticity was 4.9 (3.5, 7.4)KPa, 9.9 (6.3, 14.1)KPa, 11.4 (6.5, 20.9)KPa, and the peritoneal elasticity was 7.5 (5.7, 8.9)KPa, 11.9 (6.5, 18.6)KPa, 20.3 (11.0, 30.4)KPa, the above ultrasound indexes increased with the increase of the penetration age, and the difference was statistically significant (P < 0.05). The results of correlation analysis showed that the three factors were positively correlated with dialysis time, and the correlation coefficients were 0.4684, 0.3704 and 0.5844, respectively. The P value was less than 0.05, and the difference was statistically significant. Conclusions Patients with long-term peritoneal dialysis have specific ultrasound manifestations. Peritoneal elasticity can accurately assess the severity of peritoneal sclerosis at an earlier stage, which can be used to assist in evaluating and continuously monitoring the peritoneal status of patients with peritoneal dialysis. Early intervention is beneficial to improve the prognosis of patients.