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Patients with chronic liver disease frequently exhibit thrombocytopenia， the etiology of which is intricate and not yet fully understood. As research into the association between chronic liver disease and thrombocytopenia has progressed in recent years， investigators have recognized that the thrombocytopenia in these patients is not solely attributed to splenic hyperfunction but is also modulated to a certain extent by thrombopoietin （TPO）. The article posits the possibility of a “liver-derived thrombopoietin-centered gut-liver regulatory network mechanism”， providing a comprehensive review of the role of TPO in platelet regulation， the biological functions of platelets in patients with chronic liver disease， the diagnostic implications of TPO in chronic liver disease and cirrhosis， and the therapeutic applications of TPO and TPO receptor agonists in the treatment of thrombocytopenia in chronic liver disease. This review offers novel insights for both basic science and clinical research.