Idiopathic Thrombocytopenic Purpura (ITP) is an autoimmune disorder involving antibody and cell mediated destruction of platelets and suppression of platelet production that may predispose to bleeding. Over the past few decades, the rising awareness of treatment and it side effects and newer medications have led to newer recommendations. Treatment is mainly directed at achieving a safe platelet count to prevent a major bleeding event rather than correcting the platelet count to normal levels. Splenectomy is now a second line treatment. Corticosteroids with IVIG or anti –Rh(D), danazol, alone or in combination with azathioprine, and dapsone have been used as first line drugs. Rituximab and Thrombopoietin receptor agonists are also approved for treating adults with chronic ITP. This paper deals with all aspects of treatment modalities and their safety with latest recommendation.