Patients with a first episode of venous thromboembolism (VTE) need to be treated with heparin followed by several months of warfarin or a new anticoagulant. How to treat thereafter has previously been debated. An Australian study of aspirin for the prevention of recurrent venous thromboembolism (ASPIRE) found that 100 mg of aspirin per day was a good option for those patients being treated as described above. The results of this study are consistent with the results of last year’s WARFASA study. Pooled analysis of the two studies showed that aspirin significantly reduced VTE events by about 1/3 and also significantly reduced the composite event rate of VTE, stroke, myocardial infarction (MI) and cardiovascular death. The ASPIRE study was presented at both the American Heart Association (AHA) 2012 Annual Scientific Sessions and the New England Journal of Medicine (NEJM). The ASPIRE study randomized 822 patients with first-episode VTE who completed initial anticoagulation therapy to either the treatment group receiving 100 mg aspirin for 4 years or the placebo group. The primary endpoint was VTE recurrence. During a median follow-up of 37.2 months, 73 of 411 VTE patients on placebo recurred; 57 of 411 patients on aspirin recurred (6.5% person-years versus 4.8% person-years, P=0.09). Aspirin significantly reduced the incidence of two predefined secondary composite endpoints, VTE, MI, stroke, or cardiovascular death by 34% (P=0.01). incidence of VTE, MI, stroke, major bleeding events, and death from any cause were reduced by 33% (P=0.01). Aspirin had a calming effect and significantly reduced the incidence of major vascular events, improving the net clinical benefit. Aspirin was also inexpensive and did not require monitoring (compared with warfarin) and did not accumulate in patients with renal insufficiency (compared with dabigatran and rivaroxaban). The anti-platelet effect of aspirin can be reversed by platelet transfusions if the patient experiences a major bleed or needs emergency surgery. In addition, the use of aspirin for venous thromboembolism in this manner may result in global cost savings.