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Immune thrombocytopenia (ITP) is a disorder characterized by an isolated thrombocytopenia in the absence of an identifiable cause. Management of ITP patients varies according to the clinical presentation, physicians' experience, availability of resources, and patient preferences. Currently, multiple therapeutic options are available for the management of chronic ITP and include splenectomy, rituximab, thrombopoietin-receptor agonists, and immunosuppressant agents. To develop a common approach on the management of adult ITP patients, a meeting of a panel of hematologists experienced in the management of ITP was convened. This review focuses on the expert opinion based on local experience in the field, in light of relevant literature and guidelines, and provides expert recommendations for the diagnosis and management of adult patients with ITP in Saudi Arabia.