Stroke is a neurological disorder that is characterized by blockage of blood vessels. Clots are formed in the brain and interrupt blood flow, thereby clogging arteries and causing blood vessels to break, leading to bleeding. The study evaluates the effective use of anti-platelet drugs in ischemic and transient ischemic attack patients by various parameters that contribute to the platelet therapy which include the safety, efficacy, and cost-effectiveness. Anti-platelet drugs like Aspirin and Clopidogrel are the most frequently prescribed drugs in the treatment of stroke presently. But studies have shown the risk symptoms worsen leading to adverse drug reactions in patients. 100 patients data were collected and analysed with different statistical methods. OBJECTIVE: To determine the aptness, safe and effectiveness use, frequency of adverse drug reactions, cost-effectiveness of anti-platelet drugs in ischemic and transient ischemic attack patients. MATERIAL AND METHODS: This is a prospective observational study done for six months in the neurology department. A minimum of 100 cases of stroke were collected. These data were noted in the data collection sheet. Data include age, gender, diagnosis, lab reports, and drug therapy (drug prescribed, brand/generic name, dose, and duration). All the parameters were followed and this study analysis involve SPSS software version - 22. RESULTS: In our study of 100 patients data were collected and analysed with different statistical methods which includes the mean method, standard deviation method, chi-square method, and ANOVA test. Our study showed the most common age group of patients was 61-70 years. The incidence for the males was 65% (N=65) and for females was 35% (N=35). The most common drug prescribed was Aspirin (78%) in the maximum number of patients. Results illustrate that the majority of patients were diagnosed with Acute ischemic stroke. The adverse reaction was seen in maximum percent of patients taking dual anti-platelet drug therapy. TAB ECOSPRIN is the most cost-effective drug among all the anti-platelet drugs prescribed. CONCLUSION: It concludes the evaluation of anti-platelet drugs for safety, efficacy, and cost-effectiveness in ischemic stroke and transient ischemic attack patients. Among all the anti-platelet drugs prescribed for stroke patients - Aspirin (TAB ECOSPRIN) has shown fewer adverse effects, more efficacy in treatment, and the highest percentage of cost-saving in stroke patients compared to all other mono and dual anti-platelet drug therapy. Key Words: Anti-platelet drugs, Ischemic stroke, Transient ischemic attack, Aspirin, Adverse drug reactions, cost effectiveness.