We establish various properties of the p-adic algebraic K-theory of smooth algebras over perfectoid rings living over perfectoid valuation rings. In particular, the p-adic K-theory of such rings is homotopy invariant, and coincides with the p-adic K-theory of the p-adic generic fibre in high degrees. In the case of smooth algebras over perfectoid valuation rings of mixed characteristic the latter isomorphism holds in all degrees and generalises a result of Nizioł.