Idiopathic thrombocytopenic purpura in pregnancy is usually treated with prednisone or intravenous immune globulin. Because of the fetal risk, there are few good alternatives for women who do not respond. We report a case of refractory idiopathic thrombocytopenic purpura successfully treated with pulsed high-dose oral dexamethasone, which offered ease of administration, law cost, and low risk.