Background: There has been no consensus in prescription of low dose aspirin in patients with variant angina (VA). We examined the clinical outcomes of low dose aspirin in patients with VA confirmed by ergonovine provocation test (ERT) and concomitant with insignificant coronary stenosis (CS). Methods: A total of 424 patients admitted in Chonnam National University Hospital under diagnosis of VA were enrolled. All patients showed positive ERT: narrowing of epicardial coronary arteries more than 70% compared with original diameter responsive to intracoronary ergonovine including both focal and diffuse type. Patients were grouped by low dose aspirin (100 mg) as discharge medication: aspirin group (n=202, 71.8% male, 54.1짹11.1 years) and non-aspirin group (n=222, 62.2% male, 51.6짹10.6 years). Readmission rate due to recurrent angina, cardiac death, and percutaneous coronary intervention (PCI) during 12-month clinical follow-up. Results: Atherosclerotic risk factors were similar in both groups and the results of laboratory tests did not show any differences. During the procedure, diffuse spasm was more frequently occurred in non-aspirin group (29.2% vs. 43.7%, p = 0.002). There were more insignificant CS (defined as less than 70% diameter fixed stenosis) in aspirin group (48.0% vs. 27.0%, p <0.001). At discharge, statin was more prescribed in aspirin group (52.5% vs. 38.3%, p = 0.003). Twelve-month adverse events occurred in 83 patients (21.4%). However, rates of readmission, cardiac death, and PCI in both groups were similar. In Cox regression, aspirin at discharge did not predict 12-month adverse events (HR 1.005, 95% CI 0.60 to 1.68, p = 0.985). ST-elevation myocardial infarction as an initial diagnosis was only an independent predictor of this 12-month adverse events (HR 2.54, 95% CI 1.01 to 6.40, p = 0.048). In subgroup analysis, aspirin was not a predictor of 12-month adverse events in patients with or without insignificant CS (HR 1.08, 95% CI 0.50 to 2.33, p = 0.840, and HR 1.12, 95% CI 0.56 to 2.23, p = 0.752 respectively). Conclusion: Low dose aspirin did not predict 12-month cardiovascular events in Asian patients with VA regardless of concomitant insignificant CS.