Abstract: ITP is a common acquired autoimmune disorder defined by a low platelet count secondary to accelerated platelet destruction or impaired thrombopoiesis by antiplatelet antibodies. Aim: we aimed to assess the possible role of vincristine as second line drug in chronic steroid refractory ITP. Methods: The study was conducted in a tertiary care hospital and included all adult patients (n=50) diagnosed as ITP who were previously treated unsuccessfully with steroids. All patients received four doses of vcr 1.5 mg/m2/wk for four consecutive weeks. This was followed by observing plt count on day 1, 3 & 7 for four consecutive weeks. Results: This study showed that out of all patients enrolled for this study 80% were females (n=40) and 20% were males (n=10). Among all female patients (n=40) 4%(n=2) showed no response, 58% (n=29) were partial responders and 18% (n=9) showed complete response. We had 10 male patients out of which 18% (n=9) showed partial response and 2%(n=1) showed complete response. Overall 4%(n=2) patients showed no response, 76%(n=38) showed partial response and 20%(n=10) showed complete response. Total number of patients which showed some response to VCR including both partial and complete response was seen in 96% (48) which is significantly high and statistically significant (pvalue≤0.0001).The average plt count before VCR was 4 and peak plt count achieved on an average was 79.2.Conclusion; vcr has a double advantage (cytostatic and thrombopoetic) that would be an advantage in ITP patients. Duration of response and relapse rate needs further studies.