Chemotherapy is the main cornerstone of hematological tumor therapy. However, foot therapy and high-dose chemotherapy drugs often cause bone marrow hematopoiesis inhibition, among which thrombocytopenia is more common, which can increase the risk of bleeding, delay follow-up treatment, increase treatment costs, and even endanger life. In recent years, more and more studies have found that anti-tumor drugs can mediate thrombocytopenia through cell aging, apoptosis, autophagy and ferroptosis. Therefore, this article reviews the mechanism of chemotherapy-induced thrombocytopenia in hematological malignant tumors in recent years.