Rituximab, a CD20 monoclonal antibody, is used in chronic/refractory immune thrombocytopenia (ITP). Standard dosing is 375 mg/m2 weekly for 4 weeks alongside dexamethasone. A lower dose of Rituximab at 100 mg weekly demonstrates comparable efficacy that is well tolerated. This study evaluates lower-dose Rituximab with dexamethasone in postpubertal pediatric ITP patients. Patients treated with 100 mg weekly Rituximab for 4 weeks alongside dexamethasone at 10 mg/m2 on days 1-5 and 21-25 were assessed for response and safety. Of the 10 patients treated, six responded completely, one partially and three showed no response. Four responders maintained their response over 2 years. One Rituximab-related infusion reaction and one Dexamethasone-related adverse event were reported. Rituximab 100 mg weekly may be non-inferior to 375 mg/m2 weekly for paediatric patients.