OBJECTIVES:: To assess the cost-effectiveness of different scenarios of peritoneal dialysis (PD) provision for adults with chronic kidney disease stage 5 who are receiving hemodialysis (HD) as renal replacement therapy from the perspective of the Chilean public healthcare system. METHODS:: A Markov cohort state transition model was adapted to represent the natural history of disease, and to estimate the economic and health related quality of life impact. Three scenarios were simulated: Scenario 1 (S1) current practice 5% PD vs 95% HD, Scenario 2 (S2) 10% PD vs 90% HD, and Scenario 3 (S3) 20% PD vs 80% HD. Expected costs were measured in Chilean pesos (1 USD = 654 CLP$) and expected health benefits in quality adjusted life years (QALYs). Health related quality of life was measured using EuroQol EQ5D. A 10-year time horizon and 3% discount rate was considered for costs and outcomes. A probabilistic sensitivity analyses was performed to account for second order uncertainty. RESULTS:: The total expected costs for S1, S2 and S3 are USD 40,750, USD 41,057 and USD 41,671 respectively. The total expected QALYs for S1, S2 and S3 are 4.25, 4.29 and 4.35 respectively. The incremental cost effectiveness ratio (ICER) of changing from S1 to S2 is USD 7,675. The ICER of changing from S2 to S3 is USD 10,233. At a suggested threshold of USD 15,000 both S2 and S3 are expected to be considered as cost effective. The ICER was most sensitive to health utility scores in both PD and HD. CONCLUSIONS:: Increasing the share of PD in clinical practice is expected to be cost effective from the perspective of the Chilean public healthcare system.