The aggregation characteristics of red blood cells (RBCs) are known as important factors in the microvascular flow system, and increased RBC aggregation has been observed in various pathological diseases, such as thrombosis and myocardial infarction. This paper describes a simple microfluidic device for measuring the RBC aggregation by integrating a microfluidic slit rheometry and laser-backscattering technique. While a decreasing-pressure mechanism was applied to the microfluidic rheometry, a syllectogram (the light intensity versus time) showed an initial increase and a peak caused by the high shear stress-induced disaggregation, immediately followed by a decrease in the light intensity due to RBC aggregation. The critical shear stress (CST) corresponding to the peak intensity was examined as a new index of the RBC aggregation characteristics. The CST of RBCs increased with increasing aggregation-dominating protein (fibrinogen) in the blood plasma. The essential feature of this design was the combination of the rheometric-optic characterization of RBC aggregation with a microfluidic chip, which may potentially allow cell aggregation measurements to be easily carried out in a clinical setting.