Chemotherapy is the main cornerstone of hematological tumor therapy. However, foot therapy and highdose chemotherapeutic drugs often inhibit bone marrow hematopoiesis, which commonly causes thrombocytopenia and can increase the risk of bleeding, delay follow-up treatment, increase treatment costs, and even endanger life. In recent years, accumulating studies have found that anti-tumor drugs mediate thrombocytopenia through cell aging, apoptosis, autophagy, and ferroptosis. This article reviews the mechanism of chemotherapy-induced thrombocytopenia in hematological malignant tumors.