Acetylsalicylic acid (ASA) represents a long established backbone of antiplatelet treatment in the prevention of cardiovascular diseases. Chronic use of ASA, in particular of higher ASA doses or in patients at bleeding risk, might be associated with several severe gastrointestinal complications. Non-steroid anti-inflammatory drugs-induced gastropathy and peptic ulcerations associated with possibly fatal bleeding are the result of the systemic as well as local toxic effect of ASA on the gastric (and duodenal) mucosa. Beside the use of antisecretory drugs (proton pump inhibitors) a novel galenic formulation of ASA with enteric coating may be used to prevent these complications. This formulation enables the release of the active compound only in the intestine. The enteric-coated formulation of ASA is fully comparable with standard plain ASA in terms of efficacy and due to demonstrated better tolerability appears to be the first choice for antiplatelet treatment.