Although both rivaroxaban and aspirin have antithrombotic effects, there are differences in the mechanism of action, contraindications and other aspects, and they cannot be used as a substitute. Rivaroxaban is an anticoagulant drug, and its main mechanism of action is to inhibit the activity of coagulation factors to play an anticoagulant effect, which can be used for the prevention of thrombosis; aspirin is an antiplatelet aggregation drug, which can inhibit platelet aggregation and other processes. Aspirin is an antiplatelet aggregation drug, which can inhibit platelet aggregation and other processes. The two have different mechanisms of action, and their antithrombotic effects differ to some extent, so they cannot replace each other. Rivaroxaban is contraindicated in drug allergy, active bleeding, high bleeding risk, coagulation abnormalities, severe liver function impairment, pregnancy, lactation, etc.; aspirin is contraindicated in drug allergy, gastrointestinal bleeding ulcer, severe heart failure, etc.. The contraindications of the two have certain differences and cannot be replaced by each other. Clinical drug use is recommended to follow the doctor’s instructions, and no unauthorized use of drugs or self-adjustment of medication; if there are abnormal bleeding, rash and other adverse reactions, it is recommended to stop the use of medication and consult a doctor in a timely manner.