Background: Immune thrombocytopenia (ITP) is an autoimmune disease characterized by decreased platelet count in peripheral blood, which is caused by antibody production against surface antigens of platelets and their destruction by macrophages in reticuloendothelial system, as well as impaired thrombopoiesis. Reliable prediction of the course of the disease at time of diagnosis could be a useful tool regarding the planning of treatment, to minimize the risk of bleeding while avoiding drug complications. Objective: This study aimed was to determine clinical features and laboratory findings in children with immune thrombocytopenia (ITP) among studied children. Patients and Methods: This prospective cohort study included 48 patients categorized into 3 groups (acute, persistent and chronic). Acute group include 19 patients, persistent group include 11 patients and chronic group included 18 patients. The study was done in Hematology and Oncology Unit of Pediatric Department and Clinical Pathology Department, Zagazig University Hospitals. Results: There was significant difference between the studied groups regarding platelet count initially at diagnosis, and after 6 months and percent change in platelet count at 6 months as compared to base line (on pairwise comparison, the difference is significant only between patients with acute and chronic ITP regarding change in platelet count. Also, the difference was significant between each individual groups regarding percent change in platelet count). Conclusion: ITP in children is usually a benign disease with no or minimal bleeding. It has a high chance for spontaneous remission even without treatment. The most common presentation in ITP is cutaneous bleeding in form of petechiae and/or ecchymosis.