We describe 3 patients with thrombotic thrombocytopenic purpura (TTP) treated with vincristine. In 2 of them, multimodality treatment with plasmapheresis, acetylsalicylic acid, dipyridamole, corticosteroids, and plasma infusions did not achieve lasting remission, subsequent to which the administration of vincristine was followed by prompt and durable remission. In the third patient, 1 mg of intravenous vincristine as initial therapy in conjunction with multimodality treatment resulted in the prompt resolution of the disease. Our experience suggests that vincristine is effective in the treatment of TTP and can be used as initial treatment in combination with other modalities.