Background　There are no specific, widely accepted recommendations for the perioperative management of patients with cardiovascular disease(CVD) receiving antiplatelet therapy, and performing neuraxial anesthesia in patients receiving antiplatelet therapy is controversial due to the increased risk of spinal epidural hematoma.　Objective　To review the mechanism of action of aspirin and the clinical literature for relationships among aspirin dosage, efficacy, and safety.　Content　With a high prevalence of CVD, the appropriate perioperative management of high-risk patients treated with aspirin is a common clinical problem for surgeons and anesthetists. For this reason, many treatment decisions have to be made for patients with CVD who need cardiac and non-cardiac surgery.　Trend　Perioperative antithrombotic management is based on risk assessment for thromboembolism and bleeding, and recommended approaches aim to simplify patient management and minimize negative clinical outcomes by multidisciplinary teams.