Abstract: We report a case of active ulcerative colitis presenting primarily with recurrent purpura fulminans. During the active phase of the disease with concomitant infection, the patient developed progressive thrombocytopenia, markedly elevated D-dimer and fibrin degradation products, along with multiple thrombotic events. Based on the clinical manifestations, laboratory findings, imaging results, and histopathological examination, a diagnosis of highly suspected vaccine-induced immune thrombotic thrombocytopenia (VITT)-like syndrome was considered. This case highlights that immune-mediated thrombotic disorders should be considered in patients with active inflammatory diseases who develop thrombocytopenia, coagulation abnormalities, and rapidly progressive necrotic purpura, and that comprehensive evaluation incorporating relevant laboratory, imaging, and pathological examinations is essential for diagnosis.