Essential thrombocythemia is one of the Ph‑negative myeloproliferative neoplasms treated with hydroxyurea. An alternative strategy may be a therapy with thromboreductin. The aim of the study was to compare the effectiveness of hydroxyurea and thromboreductin treatment, defined by a decrease in the platelet count. The study group consisted of 154 patients with essential thrombocythemia diag nosed and treated at the Outpatient Clinic of Hematology in Krakow, Poland between 1995 and 2016. Patients were included in the study at the start of cytoreductive treatment. 102 patients was treated with hydroxyurea and 52 patients treated with thromboreducin. We set the limit values for the number of platelets on levels : <800 x 109/L, <600 x 109/L, <450 x 109/L and <350 x 109/L. Afterwards, the analysis of the time required to achieve each point was performed. A comparison of hydroxyurea and thromboreductin groups showed that the number of platelets at the beginning of therapy was significantly lower in patients treated with hydroxyurea. Platelets value in the last control was significantly lower in patients treated with thromboreductin than hydroxyurea. The change in total platelet count over the time was significantly higher in the thromboreductin group. Patients treated with thromboreductin had a faster platelets reduction lower than 450 x109/L. Tromboreductin is effective in reducing the number of platelets in patients with resistant essential thrombocythe mia or intolerant of hydroxyurea regardless of age