Introduction:Refractoriness to platelet transfusion therapy can be defined as post-transfusion platelet increment that is less than expected, platelet refractoriness occurs in 27% of patients who undergo a platelet transfusion, constituting a limitation when transfusing a patient with this condition.Objective: Design a pragmatic approach to the evaluation and management of patients with platelet refractoriness.We present an algorithm for their management. Material and methods:The authors conducted a search of references of recent articles addressing the subject of interest in the database MEDLINE, through PubMed.Conclusions: The management of platelet refractoriness begins with the prevention of sensitization.To date there is no method to diagnose refractoriness of non-immune origin, in many cases it can coexist with some degree of immune refractoriness.