Aim To assess the bleeding complications caused by preventing or treating of aspirin and clopidogrel for ischemic stroke (IS). Methods The databases including PubMed, EMBase, The Cochrane Library, CBM, CNKI, VIP and Wang Fang Data were retrieved by using computer, and retrieval was from the database building until September 2016. The randomized controlled trials (RCT) were collected on aspirin and clopidogrel to prevent or treat IS and causing bleeding complications. The Meta analysis was carried out by RevMan 5.2 software after 2 researchers independently conducted literature screening, data extraction and quality evaluation. Results A total of 13 RCTs, including 5204 patients, were enrolled. Meta analysis showed:(1)In the prevention of IS, compared with clopidogrel, aspirin did not increase the risks of mucocutaneous and gingival bleeding, but increased the risk of gastrointestinal bleeding; Compared with aspirin alone, aspirin and clopidogrel combination increased gastrointestinal response. (2)In the treatment of IS, compared with clopidogrel, aspirin did not increase the risks of mucocutaneous, gingival bleeding and gastrointestinal bleeding, without increasing gastrointestinal response; Compared with aspirin alone, the combination of aspirin and clopidogrel did not increase the risks of skin, mucous membranes, gums, digestive tract and brain hemorrhage, and did not increase the gastrointestinal response. Conclusion In the prevention of IS, aspirin can increase the risk of gastrointestinal bleeding when compared with clopidogrel, and the combination of aspirin and clopidogrel can increase gastrointestinal response when compared with aspirin alone.