Objective To investigate the efficacy and safety of Glucocorticoid (GC) combined with recombinant human thrombopoietin (rhTPO) or Cyclosporine A (CsA) in the treatment of primary immune thrombocytopenia (ITP). Methods A total of 48 patients diagnosed with ITP were randomly divided into GC+rhTPO group and GC+CsA group. Both groups received intravenous treatment of GC for 4 days. GC+rhTPO group simultaneously received subcutaneous treatment of rhTPO while GC+CsA group received intravenous treatment of CsA. The platelet (PLT) level of the two groups before treatment and 4 days, 7 days, 14 days, 21 days and 28 days after treatment and the effect time were compared. The effective rate, efficancy and adverse reactions of the two groups were calculated and analyzed. Results The PLT levels were different at different points (P < 0.05). The PLT level were different between the GC+rhTPO group and GC+CsA group (P < 0.05). The platelet level of GC+rhTPO group was significantly higher than GC+CsA group (P < 0.05). There was statistically significant difference in variation trends of the two groups (P < 0.05). The effect time of GC+rhTPO group was early than that of GC+CsA group (P < 0.05). The significant effective rate of GC+rhTPO group was higher than that of GC+CsA group (P < 0.05), while the overall effective rates of two groups were not different (P > 0.05). There was 1 patient in GC+rhTPO group and 2 patients in GC+CsA group with side effects. Conclusions GC combined with rhTPO is a more effective treatment and has a faster onset than the treatment of GC combined with CsA.