Objective: Indications and appropriateness of aspirin use have not been well investigated in Turkey. Therefore, the aim of this study is to investigate the prescription patterns and appropriateness of aspirin in a real-world clinical setting. Methods: The ASSOS study is a cross-sectional, multicenter registry involving consecutive cardiology patients who were using aspirin. Patients were divided into two groups according to the use of aspirin; primary prevention and secondary prevention group. The indication of aspirin use was evaluated according to 2016 the European Society of Cardiology (ESC) and 2016 the United States Preventative Services Task Force (USPTF) guidelines in the primary prevention group. Results: A total of 5007 patients (mean age 62.15± 11.05, 39% female) were enrolled. The primary prevention group included 1132 (22.6%) patients and the secondary prevention group included 3875 (77.4%) patients. Of the 1132 patients, inappropriate use of aspirin was determined in 100% of the patients according to the ESC guidelines, and 71 % of the patients according to the USPTF guidelines. Conclusion: Although there are considerable differences between the USPTF and the ESC guidelines with respect to recommendations for aspirin use in primary prevention, inappropriate use of aspirin in Turkey is frequent in real-world practice for both guidelines.