Aspirin has been well known for its anti-pyretic and anti-inflammatory action over the past century. Its main action in the gastro-intestinal tract has always been associated with erosion and ulceration. However in recent years, there has been evidence suggesting that aspirin and the more potent non-steroidal anti-inflammatory drugs (NSAIDs), could reduce the risk of gastric and colon cancer. One of the possible mechanisms in chemo-prevention is the ability to induce apoptosis in epithelial cells of the gastro-intestinal origin. This article introduces the role of apoptosis in the body and the gastro-intestinal tract. Evidence on the chemo-preventive role of aspirin and NSAIDs are listed, and the mechanisms of action discussed.