Introduction: Our study was conducted prospectively on twenty patients with acute nonhemorrhagiccerebro-vascular stroke in the period from December 2007 to December 2008aiming at evaluating and comparing gastric complications of dual antiplatelet therapy VsMonoantiplatelet therapy using upper GI endoscopy.Methods: Patients were divided into 2 equal groups (Group A, maintained on Aspocid 150mg& group B maintained on Aspocid 150 mg plus Clopidogrel 75 mg). Both groups weremaintained on antiplatelets for 1 week and evaluated endoscopically twice, according to Rypinsgrading of gastric mucosa, once upon admission and another follow up after a week ofinitiating antiplatelet therapy to detect gastric complications.Results: There was no significant difference as regard age of both groups (P value 0.496). Sexhad non significant difference (P value 0.65). There was a non significant difference betweenthe two groups regarding diabetes mellitus, hypertension, smoking, previous CVA anddyslipidemia. A non significant difference between both groups regarding neurologicalfindings (P value 0.82). Regarding Glasgow Coma Scale (GCS), there was non significantdifference between the two groups (P value 0.125). A non significant difference between thetwo groups regarding presence of gastric symptoms (P value 0.582). As regards previoususage of antiplatelets, there was a significant difference between the two groups (P value0.007). In group A, Ninety percent of patients had the same endoscopic findings (grading 0-3)at day 0 and day 7 and only 10% of patients deteriorated, regarding endoscopic findings, fromgrade 0 to grade 7. In group B, Forty percent of patients had the same endoscopic gastricfindings (grading 0-4) and 60% deteriorated—10% of them progressed from grade 1 to 7, 10%progressed from grade 2 to 7, 20% progressed from grade 3 to 7, 10% progressed from grade 0to 3 and 10% progressed from grade 3 to 6. There was statistically significant difference in bothgroups with a P value 0.0198 that indicated that gastric complication increased markedly withusage of dual antiplatelets drugs in relation to Monoantiplatelet drugs. A non significantdifference between the two groups regarding the outcome (mortality) (P value 1.0).Conclusion: The combination of dual antiplatelet therapy (Aspirin & clopidogrel) increasedgastric complications in comparison to Monoantiplatelet therapy (Aspirin) alone and so it is notrecommended.