In clinical work, we have encountered many patients with thrombocytopenia on anti-tuberculosis treatment. Most of them have only mild reduction, and after observation and adjustment of anti-tuberculosis treatment, the patients have successfully completed the treatment program and are cured of tuberculosis. However, a small percentage of patients not only fail to cure TB, but if they are not observed and treated promptly, even patients may die of bleeding due to severe thrombocytopenia. The anti-TB drug most likely to cause thrombocytopenia is rifampin, but including isoniazid, levofloxacin, and ethambutol may also cause severe thrombocytopenia. These patients are mostly middle-aged and elderly male patients, some of whom have immunocompromising diseases such as diabetes and, most commonly, combined liver disorders. They may have normal or mild thrombocytopenia before the drug and a dramatic drop in platelets after the drug is administered. The causes and treatment are discussed below. Drug-induced thrombocytopenia (DITP) is a bleeding disorder caused by a decrease in peripheral blood platelet counts (below normal) due to certain medications. Thrombocytopenia is diagnosed when the drug-induced platelet count is below 100 x 10 9/L. Severe cases can result in a reduction in platelet count to less than 5. 0 x 10 9/L. Severe thrombocytopenia caused by the use of anti-tuberculosis drugs mostly occurs 1 to 2 weeks after the use of drugs, manifested as skin bruises, bruises and mucosal bleeding, which may be accompanied by nasal bleeding, gum bleeding; severe symptoms may include gastrointestinal bleeding, hematuria or vaginal bleeding, or even intracranial bleeding, and systemic symptoms such as chills, fever, generalized aches and pains, nausea, vomiting, headache, abdominal pain, arthralgia, skin itching and flushing. However, a few patients may die suddenly due to severe disease and atypical self-reported symptoms. What are the main points of treatment for thrombocytopenia caused by anti-tuberculosis drugs? 1. If the platelet count is higher than 50×10 9/L and there is no obvious bleeding symptom, stop the anti-tuberculosis drugs temporarily and continue to observe and review for a short time. If the platelet count is lower than 50×10 9/L, stop the anti-tuberculosis drugs and other drugs that may cause thrombocytopenia. 2.It is recommended to do bone aspiration to exclude other hematological diseases and to understand the hematopoietic function of bone marrow. 3.If platelet count is lower than 20×10 9/L, platelet transfusion therapy should be performed in time. 4.If the platelet count is lower than 10×109/L, it can receive high-dose immunoglobulin intravenous infusion treatment. 5.For those who have severe bleeding symptoms, the application of corticosteroids within a short period of time after stopping the drug can promote the platelet count to rise again, but the use of hormone therapy should be cautious. Therefore, patients on anti-tuberculosis treatment are advised to observe any signs of bleeding in the course of treatment, and to follow the doctor’s instructions for regular rechecking of blood picture, etc.