Abstract Background Low dose rivaroxaban-plus-aspirin has been shown to reduce cardiovascular (CV) events in patients with stable atherosclerotic vascular disease compared to aspirin alone in the COMPASS trial. Purpose We aimed to estimate the potential benefit of low dose rivaroxaban plus aspirin in reduction of major adverse cardiovascular event (MACE, the composite of cardiovascular death, stroke, or myocardial infraction [MI]) among COMPASS-like patients in a Chinese population. Methods We retrospectively analyzed 18,693 patients with stable coronary artery disease (CAD) and/or peripheral artery disease (PAD) from 3 hospitals in Hong Kong between 2013 and 2017 for a median follow-up of 36 (IQR 19–52) months. 4,594 (24.6%) COMPASS-like patients were identified based on COMPASS trial inclusion and exclusion criteria. We estimated the absolute risk reduction (ARR) in MACE and number needed to treat (NNT) in COMPASS-like patients based on results from the COMPASS trial (NCT01776424). Results Of 4,594 COMPASS-like patients (58.1% males, mean age 75.0±13.0 years), 92.5% patients were diagnosed with CAD, 5.6% PAD, and 1.9% combined CAD/PAD. Overall, 3-year MACE rate was 7.9%; 7.8% in patients with CAD, 6.6% in PAD and 18.4% in combined CAD/PAD (log-rank p<0.01). 3-year CV mortality rate was 3.7% (3.6%, 3.5%, 11.5% in CAD, PAD and combined CAD/PAD respectively, log-rank p<0.01); 3-year stroke rate was 3.2% (3.0%, 4.6%, 6.9% in CAD, PAD and combined CAD/PAD respectively, log-rank p=0.03); and 3-year MI rate was 2.2% (2.3%, 0%, 6.9% in CAD, PAD and combined CAD/PAD respectively, log-rank p<0.01). Among COMPASS-like patients, estimated ARR in MACE with the use of rivaroxaban-plus-aspirin was 1.9% (NNT=53); 0.8% ARR (NNT=123) for CV death, 1.3% ARR (NNT=74) for stroke and 0.3% ARR (NNT=325) for MI. Conclusion Our results demonstrated that a significant proportion of “real world” Chinese patients with stable cardiovascular diseases were COMPASS-like patients. Potential clinical benefit of the addition of low dose rivaroxaban to aspirin therapy may be greater in our population than that observed in the trial, with lower number needed to treat.