Immune Thrombocytopenic Purpura (ITP) is the most common autoimmune disorder that is caused by antibody-mediated destruction of thrombocytes and impaired megakaryocyte platelet production. ITP remains a diagnosis of exclusion. Recent pathophysiologic mechanisms and therapeutical approaches of ITP have emerged. Although steroids and intravenous immunglobulins (IVIg) have still been the main therapeutic strategies, a group of patients develop resistance to those eventually and there have been some biological treatment options such as rituximab especially in the last decade. In this review article, we have summarized the therapeutic options for patients with ITP and mainly focused on the timing and potential effects of biological agents.