Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 8 2 2022 03 12 166 168 Abhishek Samprathi Fortis Hospitals,154/9, Bannerghatta Main Road, Opposite IIM, Bengaluru, Karnataka, India. Pooja Sarada Fortis Hospitals,154/9, Bannerghatta Main Road, Opposite IIM, Bengaluru, Karnataka, India. Hamza Dalal Fortis Hospitals,154/9, Bannerghatta Main Road, Opposite IIM, Bengaluru, Karnataka, India. 2021 09 11 2021 10 18 The Covid-19 pandemic has seen the emergence of various vaccines being produced at an unprecedented speed. It is not surprising that new adverse events to these vaccines are still being reported and Immune thrombocytopenic Purpura [ITP] happens to be one among them. Moderna and Pfizer vaccine have been linked to it. Association of ITP with SARS-CoV-2 vaccine is poorly understood. We present to you a case of severe symptomatic thrombocytopenia post ChAdOx1 nCoV-19 vaccination which responded to conventional therapies. Aggressive use of immunosuppressive treatment may jeopardize the intended purpose of SARS-CoV-2 vaccine. Also, the schedule and alternative vaccine for the second dose and the role early use of non-immunosuppressive treatment like Thrombopoietin receptor agonist are unclear. While the universal immunization program needs to continue, vigilance to the occurrence of severe thrombocytopenia due to vaccination is needed. https://aacc.tums.ac.ir/index.php/aacc/article/view/405