The pathogenesis of immune thrombocytopenia (ITP) asa rare autoimmune disease includes peripheral destructionof platelets in the blood and meanwhile their inappropriatebone marrow production. Although the pathogenesis of ITPis not fully understood, recent studies suggest that a loss ofimmune tolerance is mostly due to regulatory T-cell defects.Besides, the antiplatelet antibody production is triggered byT follicular helper cells by stimulating autoreactive lympho-cytes in the spleen. Cytotoxic T lymphocytes are also criticalin ITP pathogenesis, they affect both megakaryocytes andplatelets. Investigation of ITP pathogenesis is associatedwith exploring new therapeutic strategies. Recently the maintreatment approaches are directed against the recovery of Tcell immune balance. Such therapy will greatly facilitate themanagement of ITP.