Idiopatic trombocytopenic purpura (ITP) comprises up to 95 % of all trombocytopenias in childhood. It belongs to immune trombocytopenias caused by greater destruction of trombocytes. Management of therapy, according to recommendation of prof. Gadner, American and British guidelines, depends on clinical condition, degree of hemorrhage and trombocytes count. The therapy of acute ITP is recommended in „wet purpura“ and trombocytes count less than 20 x 109/l, always in patients with trombocytes count below 10 x 109/l, in life threatening hemorrhage also with trombocytes count up to 50 x 109/l. The choices of treatment are steroids (High-dose Prednison or high-dose methylprednisolon), second line therapy consists of intravenous immunoglobulin (IVIG), anti-D globulin is the other choice of therapy. In chronic ITP Cyclosporin A, Cyclophosphamide, Vincristin, Vinblastin treatment is recommended. In case of failure of therapy in acute or chronic ITP it is anti-CD 20 – monoclonal antibody, rituximab. At the department of Pediatric Oncology (Hematology Kosice) we treated with Rituximab three patients, two with acute ITP and episaxis and one with chronic ITP, trombocytes count below 50 x 109/l and mucosal hemorrhage. Successfully.