--- - |2 Abstract Recently, the roles of gene polymorphisms in poor responsiveness to aspirin were extensively investigated, with conflicting results. Therefore, we performed this meta‐analysis to better assess the relationship between candidate genetic variants and poor responsiveness to aspirin. Eligible articles were searched in PubMed, Medline, Embase and CNKI. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to detect possible associations of gene polymorphisms with poor responsiveness to aspirin. Among 53 eligible articles, a total of 22 candidate gene polymorphisms were analyzed. A significant association with poor responsiveness to aspirin was observed for GP1BA rs2243093, PTGS1 rs1330344, PTGS2 rs689466 and TBXA2R rs1131882 polymorphisms in overall analyses. Further subgroup analyses demonstrated that ITGA2 rs1126643, PTGS1 rs1330344, PTGS2 rs20417, PTGS2 rs689466 and TBXA2R rs1131882 polymorphisms were significantly associated with poor responsiveness to aspirin in Asians, whereas only GP1BA rs2243093 polymorphism was significantly correlated with this phenomenon in Caucasians. In conclusion, our findings indicate that GP1BA rs2243093, ITGA2 rs1126643, PTGS1 rs1330344, PTGS2 rs20417, PTGS2 rs689466 and TBXA2R rs1131882 polymorphisms may serve as genetic biomarkers of poor responsiveness to aspirin in certain ethnic groups. This article is protected by copyright. All rights reserved. - 'Clinical and Experimental Pharmacology and Physiology, Volume 0, Issue ja, -Not available-. '