Idiopathic thrombocytopenic purpura (ITP) of childhood has a relatively good prognosis with only 5% to 10% of patients manifesting chronic disease. Chronic idiopathic thrombocytopenic purpura is one of the disorders often benefited by splenectomy,1 but recurrences of thrombocytopenia at various time intervals following removal of the spleen may occasionally occur. Recurrences are probably due to exacerbations of indolent chronic disease; rarely, other causes may be operative. We present here a report of recurrence of ITP in a previously splenectomized patient in whom accessory splenic tissue was documented by radioisotopic scanning. Removal of the small accessory spleen was followed by return of the platelet count to normal levels.