Immune thrombocytopenia (ITP) is defined as a platelet count below 100 x 109/L, with secondary causes of thrombocytopenia being excluded. Some risk factors for the development of ITP include viral infections, Helicobacter pylori bacterial infection, other autoimmune disorders, and medications such as heparin and quinine alkaloids. The clinical presentation is highly variable and includes symptoms such as mucocutaneous bleeding and fatigue, while some patients are completely asymptomatic. ITP is considered both a hemorrhagic and thromboembolic disease, with an incidence of arterial thrombosis ranging from 1 to 2.8%. Depending on the duration of the disease, ITP is classified as acute, persistent, or chronic. In the diagnostic algorithm, secondary causes of the disease should be excluded. ITP is a diagnosis of exclusion, and there is no "gold standard" for its diagnosis. The most compelling evidence for its presence is the response to specific ITP therapy. Glucocorticoids such as dexamethasone, methylprednisolone, and prednisone, as well as ntravenous immunoglobulins, are included in the first-line treatment of patients with ITP. Corticosteroids increase the hypertrophy of adipocytes within the bone, which can lead to extravascular compression of the epiphyseal and metaphyseal nutrient vessels. The thrombophilic effect of the disease and corticosteroid therapy increase the risk of aseptic necrosis (ASN) of the bone. Magnetic resonance imaging is the most sensitive and specific diagnostic method for ASN. MRI enables the earliest diagnosis and should be ordered when ASN is suspected if the X-ray findings are normal. ASN in patients with ITP is a rare but extremely debilitating event. ASN most commonly affects the proximal epiphysis of the femur, but cases of ASN have also been described affecting the knee and shoulder. There are significant challenges in the treatment of patients with ASN and ITP. Conservative orthopedic surgeries and joint arthroplasty have shown satisfactory results in these patients, but adequate hematological care is necessary in the perioperative period. It is necessary to monitor platelet levels before, during, and after the orthopedic procedure and adjust the therapy accordingly.