Abstract: Antiplatelet therapy is a major component of the management of cerebral infarction. However, there are differences in individual responses to antiplatelet drugs which are closely related to the clinical prognosis. Therefore, accurate selection of antiplatelet drugs is of great significance. Platelet function and genetic testing are core elements of precision treatment with antiplatelet drugs. For patients with high risk of ischemic event, poor prognosis or bleeding, genetic testing and/or platelet function testing may be considered. Aspirin and clopidogrel are currently classic antiplatelet drugs, and the effectiveness and safety of other antiplatelet drugs need to be further verified. For patients who are resistant to aspirin, it is recommended to consider switching to other antiplatelet drugs rather than to increase the dose of aspirin. The strategy of clopidogrel dose adjustment based on CYP2C19 genotype remains to be studied. Patients carrying CYP2C19 loss-of-function alleles are recommended to switch to other antiplatelet drugs.