"It was emotional. I have nothing but love for this city. I have so many memories in this arena so it was hard for me out there," said the four-time All-Star, who spent nine seasons in Portland before leaving as a free agent this summer.
Kawhi Leonard finished with 20 points for the Spurs, who won their third straight.
Damian Lillard led the Blazers with 22 points, including five 3-pointers, and nine assists. Portland has lost three straight.
The game marked Aldridge’s first appearance in Portland since he signed a four-year deal worth $80 million with San Antonio in July.
Aldridge set franchise records for rebounds and double-doubles, while finishing second to Clyde Drexler in points.
Afterward, he said he understood why the Portland fans had a mixed reaction to his return.
"I definitely heard the cheers of the fans that showed me love and still supported me. And I heard the fans that were mad, and rightfully so. It might have been like 70-30 cheers to boos," he said.
While he expressed his love for Portland and his gratitude to the team for his time there, he also said he was having fun with the Spurs.
"It’s awesome, man. We have a bunch of great guys that just want to win. You’ve got Hall of Famers, you’ve got guys that have been champions over and over, and it’s very selfless that they have deferred to me and let me be myself," he said. "This team is awesome."
Spurs coach Gregg Popovich said Aldridge is still finding his way.
"He’ll get more comfortable as the year progresses," Popovich said. "It’s a new system, new players. It takes a little bit of time."
Aldridge met with a group of local kids and signed autographs about an hour before the game started.
The four-time All-Star was among four starters that the Blazers lost from last season’s 51-31 squad, joined by Nicolas Batum, Wesley Matthews and Robin Lopez. The only one left is Lillard.
Lillard said it was a little odd playing against Aldridge.
"One time Coach made a call only the team knows, it was a signal, and LaMarcus called out what we were doing," Lillard said. "We both looked at each other and laughed because he remembered it."
On Wednesday, the Spurs finished the first quarter on a 14-4 run to take a 28-24 lead. Lillard was often seen holding his right hand, and he said after the game it was because his nail had torn from his index finger.
Danny Green’s 3-pointer gave San Antonio a 41-32 lead. Portland’s Noah Vonleh was called for a foul on the shot, and Blazers coach Terry Stotts was given a technical for arguing the call.
Portland closed to 64-62 on Al-Farouq Aminu’s back-to-back 3-pointers midway through the third quarter, and Lillard’s free throws tied the score at 66.
But the Blazers were stung in the ensuing moments when starting forward Meyers Leonard was whisked to the locker room with what turned out to be a dislocated left shoulder. He did not return.
Portland couldn’t pull in front, and the Spurs pushed their lead to 97-87 on Aldridge’s basket with 6:59 left.
Blazers coach Terry Stotts said he didn’t think the players were fazed by Aldridge’s return.
"Honestly, I think for the coaches and the players it was about playing the Spurs, and, having lost two in a row, it was about getting a win at home against a very good team," he said. "So I don’t think it had the same affect on the coaches and players as maybe it did on some other people."
Spurs: The team arrived in Portland a day early and a group of players went sightseeing at Multnomah Falls, the largest waterfall in Oregon, located just east of Portland. Manu Ginobili posted pictures on Twitter.
Blazers: Guard Gerald Henderson, who had hip surgery in the offseason, made his first appearance this season for the Blazers, early in the second half. He played 18 minutes, scoring 12 points. … Lillard is the first Blazer with at least three 3-pointers in eight straight games since Damon Stoudamire over a 10-game stretch in 2005.
Six Spurs scored in double figures. Tim Duncan had 12 points, Green and Tony Parker added 11 apiece, and Ginobili scored 14 off the bench.
Aldridge was asked what the weirdest thing about Wednesday night was. His response:
"The weirdest thing was not driving to the arena, coming on a bus and then coming in this locker room. I hadn’t seen this locker room before. So this was a first time for me, so confused."
Gary Payton, the former SuperSonics great who played at Oregon State, was at the game. Payton’s son currently plays for the Beavers. Portland Timbers coach Caleb Porter was also at the game. The Timbers are in Major League Soccer’s playoffs and set to host FC Dallas on Nov. 22 in the first of a two-match series with the winner advancing to the league championship game.