We report a 63 year-old man with an acute right occipital lobe infarction coincident with idiopathic thrombocytopenic purpura. The patient's thrombocytopenia responded to steroids and intravenous immune globulin with no further cerebrovascular complications. We suggest that ITP-induced platelet microparticles contributed to our patient's stroke. Proper management of acute ischemic stroke in the setting of idiopathic thrombocytopenic purpura is unclear.