Abstract: Thrombin activated fibrinolysis inhibitor, shortly known as TAFI, is a carboxypeptidase found in plasma. It is activated majorly by thrombomodulin associatedthrombin. It stabilizes clots and inhibits their lysis by decreasing their plasminogen binding sites. Besides, it activates protein C which is necessary to halt thrombin generation. Thus, it is more regulatory than inhibitory in function. Existing as three forms TAFI, TAFIa and TAFIi, assay methods of the same are not well standardized. However, TAFI is associated with conditions like hemophilia, venous thrombosis, myocardial infarction, angina pectoris, chronic liver disease and even disseminated intravascular coagulation (DIC). This review will throw light on the role, mechanisms and involvement of TAFI in associated pathological conditions.