Cloudy dialysate in a peritoneal dialysis (PD) patient may be due to infection or other causes. In patients without infection, chylous ascites is an infrequent complication. Here we report a 69-year-old Asian woman with end-stage renal disease resulting from diabetic nephropathy who developed chylous ascites one week after Tenckhoff catheter insertion. A low-fat diet was prescribed to treat the complication, with the chylous ascites subsiding after four weeks of treatment. The literature on possible etiology and treatment of chylous ascites in peritoneal dialysis patients is reviewed.