Objective The aim of this study was to compare nutritional status in elderly patients undergoing different modalities of dialysis. Subjects and methods A cross-sectional study was performed in elderly patients on dialysis treated in Peking University Third Hospital between Jan. and Dec., 2008. Nutritional status including dietary record, blood biochemistry, subjective global assessment (SGA), and body weight were assessed for each patient. Results A total of 141 patients aged ≥65 years were included in this study. Patients were treated with hemodialysis (HD, n=63) or peritoneal dialysis (PD, n=78). In patients treated with HD and PD, the prevalence of malnutrition assessed by SGA was 33.3% and 30.8% (P＞0.05), respectively, and the dietary protein intake normalized by ideal body weight was 0.94±0.23g/kg/day and 0.87±0.27 g/kg/day (P＞0.05), respectively, without significant differences between the 2 groups. However, PD patients had significantly higher values of serum cholesterol, serum low density lipoprotein and subcutaneous fat compared to HD patients (P＜0.05). Conclusions Our findings revealed that most elderly dialysis patients maintained good nutritional status despite their dietary protein intake lower than that recommended by K/DOQI. However, abnormal lipid metabolism should be concerned in elderly PD patients.