There is an increasing use of peritoneal dialysis (PD), a less costly dialysis modality, which offers the patient the opportunity to receive dialysis in the home setting, have more independence for travel and work schedules, and preserves vascular access for future dialysis options. Various methods of peritoneal dialysis catheter (PDC) insertion are available. Percutaneous placement of PDC using ultrasound and fluoroscopy guidance is associated with high technical success rates and low risk of catheter-related complications when compared to surgical and laparoscopic methods of catheter placement. Being performed as an outpatient procedure under conscious sedation in Interventional Radiology angiosuites, the technique avoids operating room and surgical clinic scheduling inefficiencies which allows placement within 24-48 hours for urgent start PD. This offers reduced hospital stay time and cost. It also avoids the need for initial surgical consult and the involvement of an anesthesiologist. This chapter emphasizes on the indications and contraindications of PD and its advantages over hemodialysis. The details of the technique of placement using fluoroscopy and ultrasound guidance are described and supported by key images. The outcomes of PDC placement using this technique are compared to the surgical and laparoscopic techniques.