Abstract : We evaluated the efficacy and safety of biosimilar romiplostim in Indian patients with ITP. Patients (>12 years) of either gender with ITP, who had received romiplostim from Jul-2019 to Oct-2020, at Department of Clinical Hematology, Nizam's Institute of Medical Sciences, Hyderabad, India, were included. The primary endpoint was the proportion of patients with platelet response (platelet count: ≥50000/μL). Of 16 patients, majority (62.5%) were females. The mean age was 34.5 years. Seven (43.75%) patients had newly diagnosed ITP, two (12.5%) had persistent, 6 (37.5%) had chronic and 1 (0.6%) had refractory ITP. Romiplostim was initiated at 250 µg/week by subcutaneous route. At 1 month, platelet response was achieved in 50% patients, with 25% (4/16) patients achieving the response as early as the first week. The platelet response at 3 months was achieved in 87% patients. Overall, the mean platelet count increased from 12687/μL at baseline to 159625/μL at 1 month and 171000/μL at 3 months. Romiplostim treatment was overall well-tolerated without significant toxicities. Biosimilar romiplostim demonstrated improvements in platelet counts in Indian patients with ITP, and was well-tolerated.