51Cr-labeled platelet and 125I-labeled fibrinogen kinetic studies in four thrombocytopenic children with varicella infection revealed marked platelet destruction (platelet survival times 0.1, 0.4, 1.0, and 2.4 days) and relatively normal fibrinogen disappearance. The platelet count was directly related to the platelet survival time. Marrow megakaryocyte mass was increased twofold to fourfold. IgG or IgM antiplatelet antibody was present on autologous platelets in the three patients tested. These data suggest that thrombocytopenia in some patients with varicella is the consequence of immune mediated platelet destruction.