Objective To evaluate efficacy and safety of hetrombopag in the treatment of chemotherapy-induced thrombocytopenia (CIT) in patients with solid tumors. Methods From September 2021 and June 2022, patients with CIT who were treated with hetrombopag from four hospitals were enrolled. The clinical efficacy of either hetrombopag monotherapy or hetrombopag combined with recombinant human thrombopoietin (rhTPO)/ recombinant human interleukin (rhIL)-11 and the efficacy of different doses of hetrombopag were analyzed. The frequency of platelet transfusions and the incidence of adverse events were also analyzed. Results A total of 57 patients were included, in which 12 patients were in the monotherapy group (83.3% with Ⅰ-Ⅱ CIT) and 45 patients were in the combination group (64.5% with Ⅰ-Ⅱ CIT). The proportion of patients who received thrombopoietic therapy during the CIT period was significantly higher in the combination group compared to the monotherapy group (66.7% vs. 0.0%, P < 0.001). The overall responses rate was 89.5%, and responses rates at 7, 14 and 21 days after treatment were 40.4%, 77.2% and 87.7%, respectively. The responses rate was 91.7% in the monotherapy group and 88.9% in the combination group, which had no significant difference between the two groups (P = 1.000). The median peak platelet count after treatment was significantly higher in the combination group compared to the monotherapy group (151.5×10⁹/L vs. 126.0×10⁹/L, P = 0.013). In the monotherapy groups, the responses rates of 2.5 mg/d and 5 mg/d were 100.0% and 85.7%, respectively. In the combination therapy groups, the responses rates of 2.5, 5 and 7.5 mg/d were 71.4%, 91.7% and 100.0%, respectively. The response rates had no significant differences among different doses of hetrombopag in both the monotherapy and combination therapy groups (P > 0.05). After treatment, one patient need a platelet transfusion, and 4 patients in the combination group developed thrombocytosis. Conclusions Hetrombopag is effective and safe for treating CIT, in which monotherapy shows significant efficacy in mild to moderate cases, and hetrombopag combin with rhTPO or rhIL-11 is effectiveness in moderate to severe or refractory cases. However, the optimal dosage and combination regimen still need further investigation.