Background: Recent studies have shown that triglyceride glucose-body mass index (TyG-BMI) is associated with the risk of ischemic stroke and coronary artery disease. However, little attention has been paid to the association between TyG-BMI and cardiovascular disease (CVD) mortality in patients undergoing peritoneal dialysis (PD). Therefore, this study aimed to explore the relationship between TyG-BMI and CVD mortality in Southern Chinese patients undergoing PD. Methods: Incident patients receiving PD during January 1, 2006, to December 31, 2018, with baseline serum triglycerides, glucose, and body mass index (BMI) information, were recruited for this single-center retrospective cohort study. TyG-BMI was calculated based on fasting plasma glucose, triglyceride, and BMI values. The association between TyG-BMI, CVD and all-cause mortality was evaluated using a multivariate-adjusted Cox proportional hazard regression model. Results: Of 2,335 patients, the mean age was 46.1±14.8 years; 1,382 (59.2%) were male, and 564 (24.2%) had diabetes. The median TyG-BMI was 183.7 (165.5–209.2). Multivariate linear regression showed that advanced age, male sex, history of CVD, higher levels of albumin and low-density lipoprotein cholesterol, and higher urine output were correlated with a higher TyG-BMI (P<0.05). During a median follow-up period of 46.6 (22.4–78.0) months, 615 patients died, of which 297 (48.2%) died as a result of CVD. After adjusting for demographics and comorbidities, TyG-BMI was significantly associated with an increased risk of CVD mortality (hazard ratio [HR] 1.51, 95% confidence interval [CI] 1.05–2.17) and all-cause mortality (HR 1.36, 95%CI 1.05–1.75). After full adjustment, 28% risk of CVD mortality (HR 1.28, 95%CI 1.13‒1.45) and 19% risk of all-cause mortality elevated (HR 1.19, 95%CI 1.09‒1.31) when TyG-BMI increased by 1-Stand Deviation (SD) (34.2). Conclusions: A higher baseline TyG-BMI was independently associated with an increased risk of CVD and all-cause mortality in patients receiving PD.