Immune thrombocytopenia (ITP) is a hematologic disorder characterized by a low platelet count, leading to an increased risk of bleeding. This review provides an overview of the historical milestones, pathophysiology, and treatment advances in ITP. Historical perspectives trace back to Avicenna's description in the eleventh century to pivotal Harrington-Hollingsworth experiment in 1950, laid the groundwork for understanding the immune-mediated platelet destruction intrinsic to ITP. Subsequent developments in investigation techniques, such as platelet-survival studies and antibody assays, contributed to diagnostic advancements. Treatment modalities have evolved significantly from the traditional approach of splenectomy to the use of corticosteroids, immunosuppressants, and novel targeted therapies. The efficacy and safety profiles of these treatments have been refined through clinical trials and consensus guidelines. Ongoing research continues to unravel the genetic and molecular underpinnings of ITP, offering insights into disease mechanisms and potential therapeutic targets. Emerging therapies, including immunomodulatory agents, hold promise for improving outcomes and quality of life for patients with ITP. In conclusion, this review provides a synthesis of historical insights, pathophysiological mechanisms, and treatment strategies in ITP. By elucidating the complex interplay between immune dysregulation and platelet destruction, this knowledge serves as a foundation for advancing the diagnosis, management, and future therapeutic innovations in ITP.