Objective To investigate the current application and effectiveness of antiplatelet drugs in elderly people taking physical examination. Methods A total of 955 elderly patients (≥60 years old) who taking physical examination in our hospital from June to August 2015 were enrolled in this cross-sectional study. They were divided into 4 groups by treatment scheme, that is, aspirin group (n=368), clopidogrel group (n=115), dual-drug group (aspirin+ clopidogrel, n=43), and non-drug group (n=429). Their baseline clinical data and the results of thrombelastography (TEG) were collected. The application and effectiveness of the antiplatelet agents were analyzed, and the related clinical indicators influencing drug efficacy were investigated. Results Significant differences were found in the age distribution, proportions of smokers, and those with the medical history of stroke, coronary heart disease,diabetes mellitus, hyperlipidemia, as well as white blood cell count (WBC), platelet count (PLT), total cholesterol, low-density lipoprotein cholesterol (LDL-C), fasting blood glucose(FBG), creatinine, estimated glomerular filtration rate (eGFR) and glycosylated hemoglobin (HbA1c) (P<0.05), but not in the blood coagulation index (P>0.05). In aspirin group, the arachidonic acid (AA) pathway was nearly effective. The adenosine diphosphate (ADP) pathway was within the scope of effectiveness in the clopidogrel group. The ADP and AA pathway were both effective in the dual-drug group. The effectiveness was more significant in the clopidogrel group than in the aspirin group (76.52% vs 45.92%, P<0.05). Logistic regression analysis found that WBC, PLT, LDL-C and activated partial thromboplastin time (APTT) increased the risk of bleeding, while age, PLT, eGFR, HbA1c, and APTT increased the risk of thrombus. Conclusion The current application of antiplatelet agents is satisfying, which can bring benefit to the elderly.