Peritoneal fibrosis (PF) is the main cause that makes the end-stage renal disease (ESRD) patients withdraw from the peritoneal dialysis treatment. As the peritoneal tissue is immersed in the peritoneal dialysis fluid continuously, the function and morphology of peritoneal membrane are altered, leading to eventual PF, decline of peritoneal ultrafiltration volume, so that peritoneal dialysis cannot be used for treatment of ESRD patients. In recent years, more and more researches have focused on the prevention and treatment of peritoneal fibrosis. "Novel drugs" have been applied in cellular and animal models, among which pirfenidone is more remarkable for its antifibrotic activities. Here, this paper reviewed the progress of research on PF prevention and treatment in recent years, and the prospect of pirfenidone in clinical application was also discussed.