The patient was a 58-year-old woman. She was diagnosed with idiopathic thrombocytopenic purpura (ITP) when she was 41 years old. Splenectomy was performed at age 55; however, there was no response (NR). Therapy with prednisolone was continued. She underwent endoscopic examination because of dysphagia, and an esophageal tumor was revealed. She was diagnosed with esophageal squamous cell carcinoma (Mt, cT3N1M0, Stage ⅢA). She received high-dose g-globulin therapy and platelet transfusion before surgery, and the platelet count subsequently increased to 11.0×10(4) mm3. A subtotal esophagectomy was performed. The platelet count was low immediately after surgery; however, it increased after POD5. The patient was discharged without complications. She is alive without recurrence 9 years after surgery. This is the first report of esophageal cancer complicated with ITP that was not responsive to splenectomy. We report this case along with a discussion.