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Heparin induced thrombocytopenia (HIT) is an immune-mediated, low blood platelet count as a result of heparin administration. The clinical features, including the recovery of platelet count with discontinuation of heparin therapy and recurrent thrombocytopenia with repeat heparin challenge. After reviewing this chapter, the reader will learn about the different types of heparin induced thrombocytopenia (HIT), how to diagnose and manage HIT, how to manage an epidural catheter in patients who develop HIT and are being treated for it. This chapter also reviews some of the medications used as alternative anticoagulation therapy in HIT. In addition, the chapter reviews common practices of how to evaluate patients for candidacy of neuraxial anesthesia and important considerations and management concerns. Finally, this chapter discusses von Willebrand disease and considerations for neuraxial anesthesia with inherited bleeding disorders.