Introduction: Aspirin is drug that is widely used, but may cause adverse drug reactions (ADRs) in East Asian populations. ADRs are noxious and inadvertent reactions to drugs, occurring at doses usually utilised for therapy. Genetic polymorphism that causes variability in drug response may play a significant role in the development of ADRs. This study aims to identify and describe pharmacogenes that contribute to ADR of aspirin in Asian populations and determine its prevalence. Methods: The pharmacogenes implicated in ADR of aspirin were first identified using PharmGKB. Then, bioinformatics databases such as OMIM, dbSNP, ScienceDirect, EBSCO and PubMed were searched to investigate the pharmacogenes and determine their prevalence. Keyword-based search was conducted to obtain relevant literature. A narrative review of all extracted articles was executed by either summarizing or tabulating the reported data. The limitations for each study were considered and documented accordingly. Results: Thirty-six pharmacogenes were identified to be associated with aspirin toxicity and twenty-six genes were found to be important in the development of aspirin ADR such as bleeding, asthma, respiratory diseases and urticaria in East Asian populations. The evidence found was focused on East Asian populations, including Koreans, Japanese and Chinese. Conclusion: Gene polymorphisms are significantly associated with ADR occurrence alongside aspirin therapy among Asians. These genes provide a starting point to focus pharmacogenomics studies in Asian populations. However, more studies would need to be conducted to be more inclusive of all ethnics, and to further solidify the relevancy of pharmacogenes with the development of ADRs.