Background: Idiopathic thrombocytopenic purpura (ITP) is one of the most serious diseases that might be life threatening and in most centers gains a priority in urgent evaluation and management. Steroids and immunosuppressant are the 1st line therapy for ITP and splenectomy is considered an alternative solution for unresponsive cases. In last decades laparoscopic splenectomy was suggested to be a safe and a convenient procedure for patients with ITP. Objective: To assess the response of platelet count to laparoscopic splenectomy in patients with idiopathic thrombocytopenic purpura and to record any intraoperative or postoperative bleeding or complications. Patients and Methods: This Prospective study included 25 patients with ITP (6 males& 19 females) with a mean age of 32.8 ± 16.2 years. They were admitted to the surgical department at Al Maadi Armed Forces Hospitals after failure of 1st line medical treatment. Mean platelet count preoperatively was 32,070 ± 15,810. All patients had increased megakaryocytes in bone marrow aspirate and normal spleen size by ultrasonography. Pneumococcal, meningococcal and haemophilus influenza vaccines were given to all patients 2 weeks prior to surgery. Intraoperative and postoperative bleeding or complications were recorded and platelet count was measured immediately, one week and four weeks postoperatively. Results: The mean platelet count rose on the first operative day in all patients to be 135.680 ± 41.230/ml. Patients were divided into good responders (nineteen patients where platelet count was >100,000) and poor responders (six patients where platelet count was <100,000). One patient (4%) developed significant intraoperative bleeding and the procedure was converted to open surgery with good postoperative course. No postoperative bleeding was recorded. One week later, the platelet count rose to be in the range of 240,000-365,000/ml in good responders (76%). In poor responders (24%) the platelet count showed rapid drop with a range of 34,000- 41,000/ml and they were referred to the hematology department for further management. Conclusion: Laparoscopic splenectomy was found to be a safe and effective procedure in a considerable number of patients with idiopathic thrombocytopenic purpura after failure of medical treatment. A short hospital stay and a low intra-operative& postoperative complications were recorded. Keywords: Idiopathic thrombocytopenic purpura, platelet, splenectomy, bleeding.