Objective: To determine the efficacy and safety of Aspirin alone and of combined Aspirin and Clopidogrel in treatment of acute Ischemic CVA. Method: A hospital based randomized controlled trial conducted at Abbasi Shaheed Hospital, Karachi from March 2013 to August 2013. Patients with Ischemic stroke > 12 hours not known to have past ischemic symptoms with confirmation of ischemia on Head CT or MRI Brain were included.  Patients with hemorrhage or other pathology such as vascular malformation, tumor, abscess, and patients with known hypersensitivity to aspirin or clopidogrel, patients with recurrent stroke were excluded. Result: Among 56 patients with ischemic stroke the mean age of the patients was 57.50 ± 13.68 years. There were more females n=35(62.5%) compared to males 21 (37.5%) with sex ratio of 1.6:1. The risk factors like Diabetes was found in n= 32 (57.1%), hypertension in 44 (78.6%), ischemic    heart   disease    n=10 (17.9%), hypercholesterolemia n=33 (58.9%), obesity in n=38 (67.9%). The treatment groups receiving aspirin+ placebo in group 1 and group 2 receiving aspirin + Clopidogrel, the rate of restroke was found in only n=3 (5.3%) patients taking aspirin alone. However in group 2 receiving aspirin + Clopidogrel, patients reported gastrointestinal bleeding n=2 (3.5%) and intracerebral hemorrhage. The mortality rate was n=6 (0,7%). Conclusion: CRP levels are important predictors of myocardial damage and can be used as prognostic marker for acute coronary syndrome.