The therapy for immune thrombocytopenic purpura (ITP) has evolved in the recent past. In certain cases therapy for ITP remains inadequate. Thrombopoietin receptor agonists are the latest addition to the armamentarium to manage the thrombocytopenia. While romiplostim was the first second generation thrombopoietin agonist to become available, eltrombopag is particularly attractive as it is an orally bioavailable agent. This review focuses on the use, safety and efficacy of eltrombopag in various clinical conditions.