Abstract: Objective To investigate the effect of combined aerobic and resistance exercise on blood pressure variability (BPV) in patients undergoing peritoneal dialysis.Methods A total of 55 patients who received regular follow-up care at the Peritoneal Dialysis Center of the Affiliated Hospital of Xuzhou Medical University between June 2023 and December 2025 were enrolled. They were randomly divided into a control group or an exercise group. The control group received routine peritoneal dialysis and standard nursing care, while the exercise group additionally participated in a 12-week combined aerobic and resistance exercise intervention. Exercise prescriptions were individually developed based on cardiopulmonary exercise testing (CPET) results. Then, 24-hour ambulatory blood pressure monitoring was performed, and short-term blood pressure variability was assessed using the coefficient of variation (CV). Changes in BPV were compared between the two groups after the 12-week intervention.Results After intervention, the daytime systolic blood pressure CV decreased in the exercise group, which is statistically different from the control group (-0.002±0.003 vs. 0.028±0.035, P<0.001). In addition, the 24-hour systolic blood pressure CV and nighttime diastolic blood pressure CV decreased in the exercise group compared with baseline; however, no statistically significant differences were observed between the two groups. No significant changes were found in the remaining CV indices in either the exercise group or the control group.Conclusions Combined aerobic and resistance exercise can reduce certain indices of blood pressure variability in patients undergoing peritoneal dialysis and improve overall BPV, with a particularly pronounced effect on reducing daytime systolic blood pressure variability.