ObjectiveTo study the results of splenectomy for patients with idiopathic thrombocytopenic purpura(ITP), which refractory to medical therapy or with repeat recurrence of symptoms. Methods58 ITP patients who failed to respond to conservative management were treated with splenectomy and the clinical outcome was observed. Postoperatively, 52 cases were followed up for 6 months to 12 years, and in 48 of these cases the followup was more than 1 year. ResultsPlatelet count recovered to normal(≥100×109/L ) two weeks after operation in 47 cases(81.03%). The total effective rate was 79.31% when followedup for 2 months, 78.85% when followedup for 6 months and 11 cases had recurrence. ConclusionsSplenectomy is a safe and effective therapy for patients with ITP who failed to respond to conservative management or have relapse of ITP. Patients who showed temporary response to preoperative steroid therapy and those who had an early or a high amplitude of increase of platelet count after operation have better prognosis.