Immune thrombocytopenia (ITP) is the most common immune-mediated acquired bleeding disorders in children. The prognosis of majority of these patient are well, with recent complete remission. However, a few patients are facing the risk of bleeding since they do not respond to the first-line therapy, and need second-line therapy. The present second-line treatments are difficult to be popularized due to their efficacy, side-effects, costs and some other factors. The pulsed high-dose dexamethasone (HDD) therapy with its good effect, small adverse effects and low cost in adults has been used as the first-line therapy in newly diagnosed ITP, which now has attracted the attention of pediatricians. In this review, we briefly summarized the latest progress of pulsed HDD therapy for ITP in children.