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Platelet transfusion is an irreplaceable method to treat patients with platelet reduction in Hematology Department and Oncology Department. However, immunogenic platelet transfusion refractoriness is a huge challenge to patients who require repeatedly platelet transfusion. Therefore, mechanisms and reasonable transfusion strategies should be formulated to improve immunogenic platelet transfusion outcomes. This article aims to review the research progress and prospects concerning mechanisms and solutions of immunogenic platelet transfusion refractoriness, and provide rational transfusion strategies for platelet transfusion refractoriness patients, thus improving platelet transfusion outcomes.