Continuous flow peritoneal dialysis (CFPD) presents many potential advantages over any conventional peritoneal dialysis modality. Foremost are the impressive clearances achieved by CFPD in clinical studies, approaching those of quotidian hemodialysis. The principal limitation of CFPD is its inability to provide adequate and consistent ultrafiltration in clinical practice, contrary to the high ultrafiltration predicted by theoretical models. There is a good possibility that this discrepancy is due to poor mixing, streaming, and recirculation of dialysate related to inadequate peritoneal access. Novel access designs are encouraging but await longitudinal clinical testing to prove their superiority.