Tissue factor (TF) is the primary cellular initiator of the coagulation protease cascade. It plays an essential role in hemostasis to limit hemorrhage in the event of vascular injury. Indeed, loss of TF is incompatible with life. Recent studies have suggested that TF also plays non-hemostatic roles in blood vessel development, tumor angiogenesis, tumor metastasis, cell migration, and inflammation. This review discusses the roles of TF in hemostasis, thrombosis, and inflammation in the heart as well as other potential roles of TF in the maintenance of cardiac muscle.