Platelets (thrombocytes) are small pieces of cell that play an important role in blood clotting by clumping and forming plugs when necessary. Thrombocytopenia, defined as a platelet count of less than 150x109/L. Causes of thrombocytopenia include increased breakdown and destruction of platelets, reduced production of platelets or platelets trapped in the spleen. Thrombocytopenia should be suspected when a child presents with a history of easy bruising or bleeding, particulary mucosal or cutaneous bleeding. The principal management goal in all patients who have thrombocytopenia is to maintain a safe platelet count to prevent significant bleeding. The most common reason of thrombocytopenia in children is idiopathic thrombocytopenic purpura (ITP). Idiopathic is a term indicating that there is no known cause for the drop in platelets. What is inderstood is that the immune system is destroying platelets, resulting in easy bruising and abnormal amounts of bleeding. In most children, ITP is acute and may be mild enough to resolve on its own without medical intervention. The most common treatment involves corticosteroids that interrupt the immune system's attack on blood platelets. In severe cases, splenectomy and stronger immunosuppressive medications may be necessary to get the condition under control. Thrombocytopenia is either present at birth or develops in the first 72 hours of life in 75% of the neonates. The majority of newborns with thrombocytopenia are born prematurely after pregnancies complicated by placental insufficiency and/or fetal hypoxia. 25-30% cases of neonatal thrombocytopenia are ralated with increase platelet consumption or sequestration to the spleen. Transplancental passage of maternal platelet alloantibodies and autoantibodies account for 15-20% of thrombocytopenia present at birth. Disseminated intravascular coagulapathy associated with perinatal asphyxia and sepsis is responsible for 10-15% cases of neonatal thrombocytopenia.