The pathophysiology and susceptibility of children to primary immune thrombocytopenia are linked to polymorphisms of the interleukin (IL)-1B and IL-1 receptor (IL-1R) antagonist genes. To investigated the association between the susceptibility and severity of primary ITP in children and the IL-1B and IL-1R antagonist gene polymorphisms. This comparative case-control study was con-ducted at the Menoufia University Hospital Hematology and Oncology Unit, Pediatric Department, between Au-gust 2022 and September 2023. The children were di vided into patients (28 boys, 22 girls) who received hospital and outpatient clinic care and controls (50 healthy age- and sex-matched children). The mutant homozygous GG genotype and mutant G allele of rs16944 of the IL1B gene were consi-derably greater in patients than in controls (P<0.001). Furthermore, the mutant homozygous II/II genotype and heterozygous I/II genotype of the IL-1R antagonist gene were considerably greater in the case versus control group. The mutant II allele was significantly more prevalent in patients versus controls (P<0.001). IL-1B and IL-1R antagonists may have a major impact on the development of immune thrombo-cytopenia. Furthermore, we found a relationship between IL-1B and IL-1R antagonist gene polymorphisms and the etiology of and children's.