OBJECTIVE： To evaluate the economic efficiency of aspirin for primary prevention of cardiovascular diseases （CVD） in China. METHODS： Based on the results of 2016 USPSTF summary analysis and published literatures at home and abroad， TreeAge Pro 2011 software was used for Markov model assumption and establishment. Ten-year cost-utility analysis for primary prevention of CVD by 2 intervention measures as giving aspirin or not giving aspirin was performed for undiagnosed patients or patients without CVD. The incremental cost-effectiveness ratio（ICER） was calculated. RESULTS： Compared with non-aspirin group， 1.68 quality adjustment life year （QALY） for 10-year health outcome was increased in aspirin group， while the cost was increased by 5 729.221 yuan and ICER was 3 401.686 yuan/QALY， which was far below GDP per capita （59 660 yuan）. Certainty sensitivity analysis and probability sensitivity analysis showed that the evaluation results were stable. CONCLUSIONS： Aspirin is of 10-year pharmacoeconomic advantages in the primary prevention of CVD in China.