Aim To research the therapeutic effect of load-dose clopidogrel combined with aspirin on transient ischemic attack （TIA） of posterior circulation.Methods A total of 84 patients with transient ischemic attack of posterior circulation hospitalized at our hospital between May 2011 and October 2013 were randomly bisected into therapy group and control group. 42 patients in control group were administrated with aspirin, while 42 patients in therapy group were administrated with load-dose clopidogrel combined with aspirin. After 4 weeks’ treatment, curative effects, platelet count and cerebral microbleeds （CMB） were compared between the two groups.Results After 4 weeks’ treatment, therapy group showed better curative effects than those in control group（incidences of significant efficiency: 57.14% vs. 35.71%, P<0.05 incidences of efficiency: 85.71% vs. 54.76%, P<0.05）. The platelet count and CMB of the two groups before and after the treatment had no statistical difference （P>0.05）. Neither group had systemic bleeding and other serious adverse events.Conclusions Load-dose clopidogrel combined with aspirin has a significant curative effect on transient ischemic attack of posterior circulation. Efficiency and safety suggest the worth of clinic promotion.