【Abstract】 Objective Metaanalysis method was used to evaluate the association between the cyclooxygenase polymorphism and aspirin resistance in the patients with cardiovascular and cerebrovascular diseases. Methods We searched China Biological Medicine (CBM), China National Knowledge Infrastructure (CNKI),EMBase and PubMed database. The casecontrol studies contained cyclooxygenase polymorphism and aspirin resistance were selected. The data were extracted in duplicate and analyzed by STATA software. Results 13 articles with 3995 cases were included. Results There were statistically significant with COX-1 A1676G allele frequency in the aspirin resistance group and the aspirin sensitive group. COX-1 C50T, COX-2 G765C polymorphism and allele frequency, COX-1 A1676G polymorphism were no statistically significant in the aspirin resistance group and the aspirin sensitive group. Subgroup analysis showed that COX-2 G765C polymorphism in the aspirin resistance group and the aspirin sensitive group were statistically significant with Chinese people. Conclusion The metaanalysis showed significant association between the COX-1 A1676G allele and aspirin resistance in patients with cardiovascular and cerebrovascular diseases. The COX-2 G765C polymorphism significant association with aspirin resistance in Chinese people with cardiovascular and cerebrovascular diseases。