It is necessary for some conditions to occur at the same time so that aspirin induced gastric mucosa injury occurs. The definite condition that is necessary for the development of gastric mucosa injury by aspirin is the direct injury with the aspirin and the presence of the gastric acid. The pathologic central mechanism is the inhibition of cyclooxygenase, the disturbance of microcirculation and pro-apoptotic signaling. At all events, it is a theme for gastroenterologists to establish a mean to prevent the gastric mucosa injury induced by aspirin.