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Introduction:Preterm pregnancies complicated by Immune Thrombocytopenic Purpura, severe pre-eclampsia, Rh-negativity with severe IUGR and present significant maternal and fetal risks,requiring meticulous management. Aims and Objectives: This report aims to describe the management of a preterm pregnancy with ITP and severe pre-eclampsia, focusing on the implications of severe fetal growth restriction (IUGR) and oligohydramnios. The objective is to improve outcomes through targetted interventions and monitoring. Materials and Methods-The patient was being managed by a multidisciplinary team since 1st trimester.Investigations included serial ultrasound for fetal growth and amniotic fluid assessment, blood pressure monitoring, laboratory tests (including platelet count,ICT and liver function ), and administration of Anti-D immunoglobulin. Intravenous Immunoglobulins were the mainstay of management. Corticosteroids were administered for fetal lung maturity. Platelet transfusion and antihypertensives were initiated. Early Delivery was done by cesarean section despite a total platelet count of 23000/microlitre. Results: The patient successfully underwent a cesarean section with pre-operative platelet transfusion,with moderate PPH.The neonate, though preterm and growth-restricted, showed stable postnatal adaptation with the assistance of NICU care. Postpartum management included Blood Pressure control and management of ITP. Maternal and neonatal outcomes were favorable, highlighting the importance of prompt, coordinated care in complex, high-risk pregnancies. Conclusion: This case underscores the need for comprehensive, multidisciplinary approaches in managing complex obstetric cases involving ITP, severe preeclampsia, Rh-negative status, and fetal growth restriction, highlighting the importance of routine Antenatal Checkup, timely intervention and careful monitoring for optimal outcomes.