〔Abstract〕 Objective To investigate the effect of different degree of antiplatelet aggregation therapy and thromboelastic diagram(TEG) on cerebral microbleeds in patients with atherosclerotic cerebral infarction. Methods A total of 150 patients diagnosed with acute cerebral infarction and given aspirin were examined by magnetic sensitive cranial magnetic resonance(SWI) and TEG and followed up for 90 days. According to whether the number of CMBS increased by>3 and the result of TEG detection compared with on admission,the patients were divided into CMBs and no CMBs group, platelet aggregation in good group(aspirin inhibition rate>75%), the effect of general group(50% Results ① CMBs and arachidonic acid(AA) inhibition rate, uninhibited platelet activity(MA-AA), Angle, coagulation reaction time(RT), age, diabetes, high-density lipoprotein(HDL-C), NIHSS score, leubic osteoporosis had statistically significant differences(P<0.05). ②The related variables selected from the single factor analysis were selected into the logistic multi-factor regression analysis, and age, HDL-C, AA inhibition rate, MA-AA, RT were risk factors for CMBs(P<0.05). ③The difference between the good group and the invalid group was statistically significant in CMBs, number of stroke, KT, RT and MA-AA(P<0.05). There was no significant difference in CMBs between the general group and the invalid group(P>0.05), and there was significant difference in the number of stroke, time of blood clot formation(KT), RT, and MA-AA values(P<0.05). There was no significant difference in the number of stroke between the good group and the general group(P>0.05), but there was significant difference in CMBs, RT value and MA-AA(P<0.05). Conclusion KT, RT and MA-AA are effective indicators of coagulation function and antiplatelet ability. Advanced age, HDL-C, high AA inhibition rate, low MA-AA and prolonged RT are risk factors for CMBs. Antiplatelet therapy under the guidance of TEG keeps the inhibition rate of aspirin between 50% and 75%, which is more scientific in the secondary prevention of cerebral infarction. It is of guiding significance to reduce hemorrhage transformation and CMBs after cerebral infarction and prevent long-term cognitive decline in patients.