Background: A high glucose content in peritoneal dialysis (PD) solution may result in unfavorable changes on peritoneal character and worsened metabolic profiles. We conducted this retrospective cohort analysis to investigate the impact of initial glucose load on long-term outcomes of PD patients. Methods: A total of 90 patients newly started on PD were enrolled. All subjects were divided into low, medium, or high glucose load equally in patient number according to the average dialysate glucose concentration prescribed in the first 6 months from PD initiation. Cox’s regression was used for survival analyses and linear regression was used for analyses of determinants for glucose load. Results: The mean follow-up period was 40.1 ± 11.8 months. Patients with higher glucose load showed a significantly worse cumulative technique survival (log rank p = 0.002). In Cox’s regression analysis, patients with lower glucose load had significantly better technique survival (p = 0.035). In linear regression analysis, preexisting diabetes mellitus (p < 0.001), lower serum albumin (p = 0.012), and lower weekly renal Kt/V (p = 0.019) were significantly correlated with higher glucose load. Conclusions: Higher glucose load during the initial period of PD was associated with higher prevalent diabetes mellitus, lower serum albumin, and lower residual renal function, and effectively predicted worse survival of PD therapy.