Objective      To determine the efficacy and safety of aspirin and clopidogrel compared with them alone in secondary prevention of stroke of patients with symptomatic carotid mild stenosis.       Methods      Consecutive patients diagnosed as mild symptomatic carotid stenosis in our department from January 2009 to August 2013 were recruited in this study. Digital subtraction angiography (DSA) showed their stenosis was less than 50%. All patients took statins medication

and received combined antiplatelet drugs

aspirin and clopidogrel (double antiplatelet group)

or aspirin or clopidogrel alone (mono antiplatelet group). Their modified Rankin score (mRS score)

the US National Institutes of Health Stroke volume neurological impairments score (NIHSS score) at admission

and the recurrent stroke and the adverse vascular events within 1 year was collected.       Results      A total of 151 patients were enrolled

including 52 patients receiving mono-antiplatelet and 99 double-antiplatelet

and finally 48 and 93 patients were enrolled respectively for the 2 groups because 10 patients were lost during follow-up. The ipsilateral stroke recurrence rates were 8.3% and 2.1% respectively in mono-antiplatelet and double-antiplatelet group(P0.05)

while the non-ipsilateral recurrence of stroke rate were 2% and 1.1% (P0.05)

the incidences of bleeding were 0 and 11.8% (P0.05).Significant difference was found in the carotid stenosis rate [(46.70±5.16)% vs (34.70±9.31）%

P0.05] and extracranial carotid total plaque area [（86.15±17.15)% vs （44.88±52.59）%

（P0.05）] between the patients with lateral stroke recurrence and those without

but not in maximum carotid intima-media thickness (IMT) and plaque feature（P0.05）.       Conclusion      Clopidogrel or aspirin also is more safe than combined them together in secondary prevention of stroke of patients with symptomatic carotid mild stenosis.