Immune thrombocytopenia (ITP) is an autoimmune disease resulted from antibody-mediated destruction of platelets. Incidence of ITP increases with the age of patients, so the diagnosis and treatment of ITP in the elderly should be paid more attention. On the one hand, diagnosis is more difficult in elderly ITP patients due to increased presence of comorbidities. On the other hand, first-line treatment based on glucocorticoid and/or intravenous immunoglobulin (IVIG) is less effective in elderly patients with ITP than in younger patients, and is more likely to develop complications such as diabetes, hypertension, thrombosis and bleeding, and osteoporosis etc.. Subsequent treatment of elderly patients with ITP includes thrombopoietin receptor agonist (TPO-RA), rituximab, dapsone, and danazol, etc.. Splenectomy is generally considered as an option when other treatments fail. In order to provide reference for the treatment of elderly patients with ITP, this article reviewed the research progress on treatment of elderly patients with ITP in recent years.