Tissue factor is closely related to the initiation and progression of atherosclerosis, and tissue factor pathway inhibitor(TFPI) is the main inhibitor of tissue factor-mediated coagulation. Ample experimental evidence indicates that TFPI has inhibitory effect on endothelial cell activity, the function of macrophages and smooth muscle cell proliferation and migration. This review focusses on the inhibitory effects of TFPI on the initiation and progression of atherosclerosis.