Bleeding in patients with low platelet counts is an important anesthetic challenge. We report a case of a 22-year-old woman who presented with a ruptured extrauterine pregnancy. The patient was a known case of immune thrombocytopenic purpura and she was on treatment with steroids. Her Hb was 6 g/dl and platelet count was 5000/ml. The postoperative period was uneventful and the patient was discharged 8 days after surgery. Here, we discuss the management and outcome of this rare presentation performed successfully under general anesthesia without the use of intravenous immunoglobulin that is an important agent for preoperative management of a planned surgical procedure for immune thrombocytopenic purpura patient to increase platelet count. The duration of surgery was 1 h. Hemostasis was achieved in this period as well.