Fungal peritonitis is a rare, but serious, complication of continuous ambulatory peritoneal dialysis (CAPD). We report a case of peritonitis caused by Aspergillus oryzae in a man on CAPD therapy who was treated successfully with amphotericin B and caspofungin, followed by itraconazole and removal of the peritoneal catheter. A oryzae was identified by using sequence analysis of the ribosomal DNA genes. Of 10 reported cases since 2003, the mortality rate was 30%. Removal of the CAPD catheter and systemic antimycotic therapy are essential to achieve clinical cure in patients with fungal CAPD-related peritonitis.