Aim: Aim of our study is to compare the efficacy of rivaroxaban and aspirin in prevention of reoccurrence of stroke in patients with left atrial cardiomyopathy and unknown stroke. Background: Stroke develops by the obstruction of blood circulation to the brain; it could be challenging to ascertain the root cause, extent, and cognitive effects of a stroke if its history is unclear. The condition known as left atrial cardiomyopathy (LAC) carries risk of an increased incidence of stroke. Studies in past have studied the effect of Rivaroxaban and aspirin and both are effective methods when used separately. Comparison of the effects has different results. Methodology: Cross-sectional study Results: The primary outcome, stroke recurrence, was lower in the Rivaroxaban group compared to the aspirin group (3.4% vs. 18.8%, respectively, p= <0.01). Discussion: Rivaroxaban is more effective than aspirin. Conclusion: Our study confirmed the findings of most of the previous studies.