In patients with severe idiopathic thrombocytopenic purpura(ITP), life-threatening hemorrhage such as intracranial or gastrointestinal hemorrhage can occur spontaneously. In this emergency situation. an attempt to increase platelet count should be done. In general, appropriate regimens include intravenous immunoglobulin and high-dose parenteral methylprednisolone either alone or in combination. These treatments should be followed by platelet transfusions, although platelets might be rapidly removed from the circulation. In this article, the strategies for emergency treatment of severe bleeding in ITP is briefly reviewed.