Objective: To evaluate the clinical efficacy of Pegmolesatide and its protective effect on myocardial function in patients undergoing peritoneal dialysis with concomitant chronic renal anaemia. Methods: A total of 80 patients with chronic renal anaemia receiving peritoneal dialysis treatment were enrolled in this study. They were divided into an observation group (n=40) and a control group (n=40) according to different treatment methods. The observation group received Pegmolesatide, whereas the control group was treated with erythropoietin. After a 12-week treatment period, the nutritional status indicators [haemoglobin (Hb), haematocrit (Hct), and red blood cell count (RBC)], iron metabolism parameters [serum ferritin (SF) and transferrin saturation (TSAT). and soluble transferrin receptor (sTfR)], myocardial injury markers [Cardiac troponin I (cTnI), lactate dehydrogenase (LDH), and creatine kinase (CK)], oxidative stress-related indicators [Serum superoxide dismutase (SOD) and malondialdehyde (MDA)], and the incidence of cardiovascular events were compared between the two groups. Results: Following treatment, both groups demonstrated increased in Hb, Hct, and RBC (P0.05). The levels of SF and TSAT were elevated, while sTfR levels were reduced in both groups compared to pre-treatment values (P0.05). cTnI, LDH, and CK levels were lower after treatment in both groups compared to pre-treatment levels (P<0.05), with the observation group exhibiting lower values than the control group (P<0.05). SOD levels increased, while MDA levels decreased in both groups after treatment (P<0.05). The observation group showed higher SOD levels and lower MDA levels than the control group (P<0.05). The total incidence of cardiovascular events was lower in the observation group than in the control group (10.00% vs. 27.50%, P<0.05). Conclusion: In patients undergoing peritoneal dialysis with chronic renal anaemia, Pegmolesatide demonstrates comparable efficacy to erythropoietin in correcting anaemia and improving iron metabolism. However, Pegmolesatide shows superior benefits in reducing myocardial injury, alleviating oxidative stress, and lowering the risk of cardiovascular events.