Thrombocytopenia is a common manifestation of tumors, which is usually caused by myelosuppression caused by bone marrow involvement of malignant tumor cells or radiotherapy. Immune thrombocytopenia (ITP), as a paraneoplastic syndrome, is more common in lymphatic proliferative neoplasms and rheumatic diseases, less common in solid neoplasms, and has not been reported in peritoneal epithelioid mesothelioma.Herein, we report a 45-year-old patient with peritoneal epithelioid mesothelioma who received remission of thrombocytopenia after treatment with hormones, intravenous human immunoglobulin, and thrombopoietin receptor agonists, as well as subsequent surgery and chemotherapy for the tumor.