Objective To study the efficacy and safty of low dose rituximab therapy in elderly patients with chronic refractory immune thrombocytopenia(ITP) .Methods 36 elderly patients with chronic refractory ITP were collected from Xingtai People′s Hospital of Hebei ,the patients were given intravenous injection of intravenous rituximab at the dose of 100 mg once weekly for 4 consecutive weeks ,observing the efficacy and adverse reaction and following up for 12 months .Difference of platelet (PLT ) ,white blood cell (WBC) ,cluster differentiation 8 + (CD8 + ) ,CD19 + eukomonocyte number and immunoglobulin (IgG ,IgM ,IgA )were compared before and after treatment .Results The responses of complete remission (CR)were 17 casese(47 .2% ) ,remission (R) were 11 casese (30 .6% ) and no remission (NR) 8 casese (22 .2% ) respectively ,2 patients experienced mild dizziness and chest tightness ;PLT were significantly increased ( P = 0 .001) after treatment ,CD19 + lymphocyte count decreased significantly (P =0 .001) ,WBC ,CD8 + lymphocyte and serum immunoglobulin IgG ,IgM ,IgA showed no significant difference before and after treat-ment(P> 0 .05) .Conclusion Low dose rituximab had better clinical efficacy for the treatment of elderly patients with chronic re -fractory ITP ,low dose rituximab may be a effective treatment in elderly chronic refractory ITP patients with minor adverse reac -tions .