Summary: Despite the ongoing progress in the antiplatelet therapeutic strategies and implementing of new drug groups, the results of preventive therapy remain still unsatisfactory. Hence, it is not surprising that the optimising of antiplatelet and antithrombotic therapeutic algorithms should constitute the pivotal priority in cardiovascular prevention Nowadays, the acetylsalicylic acid (ASA) is considered to be one of the most commonly prescribed drugs, as reported worldwide annually. Several decades of studies, especially those conducted according to the evidence based medicine principles, have clearly demonstrated that ASA is one of the most effective drugs in the healthcare system. This brief review paper summarizes the current knowledge regarding the use of the oldest antiplatelet drug with respect to the present guidelines in cardiovascular medicine, and presents the importance of ASA in oncological prevention and in the maternal-fetal medicine.