Methods: Case report: 24 year old male with no past medical history came to emergency department reporting hemorragic skin rush at inner thgh area 36 hours after the second dose of Pfizer-BioNTech COVID-19 vaccine. A complete blood test showed a platelet count of 1 × 109/L. Patient did not have a prior history of thrombocytopenia, except a lab result of platetet count 135 × 109/L 45 days ago, . and other causes of thrombocytopenia were ruled out by history and pertinent lab data. No signs of thormbosis were found and D- dimers were at normal rangeResults: He received 14 units of platelets, two doses of intravenous immunoglobulin and oral dexamethasone for 4 days resulting in normalization of platelet counts.Conclusions: COVID-19 vaccination induced ITP has been recently acknowledged. However, given very few cases and limited data, currently there are no guidelines for management of ITP caused by COVID-19 vaccine as well as vaccination of people with predisposing conditions. furthemore, there has to be a differential diagnosis from Vaccine Induced Thrombotic Thrombocytopenia (VITT), at the onset of clinical manifestation Methods: Case report: 24 year old male with no past medical history came to emergency department reporting hemorragic skin rush at inner thgh area 36 hours after the second dose of Pfizer-BioNTech COVID-19 vaccine. A complete blood test showed a platelet count of 1 × 109/L. Patient did not have a prior history of thrombocytopenia, except a lab result of platetet count 135 × 109/L 45 days ago, . and other causes of thrombocytopenia were ruled out by history and pertinent lab data. No signs of thormbosis were found and D- dimers were at normal range Results: He received 14 units of platelets, two doses of intravenous immunoglobulin and oral dexamethasone for 4 days resulting in normalization of platelet counts. Conclusions: COVID-19 vaccination induced ITP has been recently acknowledged. However, given very few cases and limited data, currently there are no guidelines for management of ITP caused by COVID-19 vaccine as well as vaccination of people with predisposing conditions. furthemore, there has to be a differential diagnosis from Vaccine Induced Thrombotic Thrombocytopenia (VITT), at the onset of clinical manifestation