We aimed to investigate the relationship between demographics, clinical features, laboratory findings including monocytosis and clinical course in children with immune thrombocytopenia (ITP). Data of 100 ITP patients were analysed. Complete blood count findings of the patients at certain time points were evaluated to classify the disease as acute, persistent and chronic. An effect of sex on chronicity was not observed (P = 0.166). Of the patients enrolled in the study, 38% (n = 38) had chronic course. The mean age of patients with the chronic course was 7 +/- 4.1 years, which was significantly higher than the other groups (P = 0.007). Sixty-five percent (n = 13) of the patients presenting with mucosal bleeding and 27.4% (n = 20) of the patients presenting with skin bleeding became chronic (P = 0.008). MPV was found to be significantly high in chronic ITP patients (P = 0.049). Monocytosis was noted in 80% of the patients at diagnosis. Intravenous immunoglobulin was used in 84% of the patients with acute ITP; 33% of them developed chronic ITP. The age at diagnosis, presence of mucosal bleeding and increased MPV on admission were high-risk factors for the development of the chronic course. Monocytosis was detected in 80% of the patients on admission, and it may play a role in the pathogenesis of ITP.