Objective To explore the predictive value of interleukin (IL) 37 and IL-17A on outcomes in adult patients with primary immune thrombocytopenia (ITP) and the correlation with programmed death receptor-1 (PD-1) and programmed death receptor ligand-1 (PD-L1). Methods The data of 152 patients with ITP in the hospital were retrospectively analyzed from April 2022 to March 2024. All patients were treated with glucocorticoid or/and gamma globulin. After 1 month of treatment, the patients were divided into good outcome group (117 cases) and poor outcome group (35 cases) by means of the outcomes. The baseline data, IL-37, IL-17A and expression rates of PD-1 and PD-L1 were compared between groups. Logistic regression analysis was used to explore the influencing factors of outcomes of ITP patients. Receiver operating characteristic curve (ROC) was drawn to analyze the predictive value of IL-37 and IL-17A levels on the outcomes of ITP patients. Pearson correlation coefficient was adopted to analyze the correlation of IL-37 and IL-17A levels before treatment with expression rates of PD-1 and PD-L1.Results There were differences in bleeding score, positive expression of autoantibody spectrum, platelet count before treatment, levels of IL-37 and IL-17A and expression rates of PD-1 and PD-L1 among ITP patients with different outcomes (P＜0.05). Logistic regression analysis indicated that bleeding score, positive expression of autoantibody spectrum, platelet count before treatment, IL-37 level, IL-17A level and expression rates of PD-1 and PD-L1 were independent influencing factors for the outcomes of ITP patients (P＜0.05). ROC analysis found that IL-37 and IL-17A before treatment had predictive value on outcomes of ITP patients (P＜0.05). Pearson correlation coefficient revealed that the levels of IL-37 and IL-17A before treatment were positively correlated with expression rates of PD-1 and PD-L1 (P＜0.05). Conclusion The levels of IL-37 and IL-17A and expression rates of PD-1 and PD-L1 are independent influencing factors for outcomes in ITP patients. IL-37 and IL-17A have predictive value on outcomes, and are positively correlated with expression rates of PD-1 and PD-L1