The present study investigates the aspirin prescribing pattern and guidelines-adherence evaluation for primary prevention of cardiovascular diseases at a teaching hospital. A total of 816 patients were included in the study, the patients who received aspirin aged 60-69 (29.65%), followed by patients aged 50-59 years old (29.53%) and 70-79 years old (22.91%). Demographic information shown that the majority of the patients were males (58.55%). The BMI revealed that 85.78% of patients were obese. The majority of the patients have diabetes 78.67%, hypertension 74.38%, and dyslipidemia 65.68%. The mean systolic blood pressure was 136 ± 7.4 and diastolic blood pressure was 74.9 ± 5.2. After applying aspirin candidacy calculation, only 6% patients were highly recommended to be on aspirin, 49% patients had reasonable recommendation of aspirin, 27% patients use aspirin based on "may be considered" recommendation, and 23% patients were on aspirin with no indication or recommendation. The study highlights the importance of following the international recommendations in aspirin prescribing, and flags the inappropriate use and prescribing by our healthcare providers. The current study encourages further investigation to be carried out which should include patient and clinician education, to well understand and alleviate the inequalities in aspirin use and adherence. Further studies are also warranted to understand of the prescribing pattern and to provide solutions to avoid aspirin associated complications.