Objective: Encapsulating peritoneal sclerosis (EPS) is a rare but severe complication in maintenance peritoneal dialysis (PD) patients. However, precise diagnostic indicators are currently lacking. This study aimed to analyze the CT radiological characteristics of patients developing EPS after PD to identify sensitive diagnostic and prognostic indicators. Methods: A total of 18 patients who developed EPS after PD at our hospital's Department of Nephrology between January 2022 and December 2024 were enrolled. Patients were categorized based on disease severity: 8 patients with mild EPS constituted the mild group, and 10 patients with severe EPS constituted the severe group. Clinical and CT radiological characteristics were compared between the two groups, including the presence of peritoneal calcification, peritoneal thickening, bowel wall thickening, small bowel adhesions, encapsulated fluid, and small bowel dilatation. The peritoneal thickness, peritoneal CT value, small bowel wall thickness, and small bowel wall CT value were measured twice in each of the four abdominal quadrants. Results: The PD vintage was significantly longer in the severe EPS group compared to the mild group (156.8 ± 57.0 vs. 87.4 ± 60.4 months, P = 0.024). The proportion of hemorrhagic ascites was higher in the severe group (60.0% vs. 0.0%, P = 0.013), as was the serum magnesium level (0.9 ± 0.1 vs. 0.8 ± 0.2 mmol/L, P < 0.001). No statistically significant differences were found between the two groups in the prevalence of peritoneal calcification, peritoneal thickening, bowel wall thickening, small bowel adhesions, encapsulated fluid, or small bowel dilatation. However, the mean peritoneal thickness (3.8 ± 0.7 vs. 2.8 ± 0.7 mm, P = 0.009) and the mean peritoneal CT value (30.4 ± 7.9 vs. 16.6 ± 6.3, P = 0.001) were significantly greater in the severe EPS group compared to the mild group. Tamoxifen was used more frequently for treatment in the severe group (70.0% vs. 12.5%, P = 0.025). Conclusion: EPS following PD exhibits specific CT radiological characteristics. Peritoneal thickness and peritoneal CT value derived from CT imaging may serve as important indicators for both the severity and potentially the occurrence of this disease.