Studies of antistasin, a potent factor Xa inhibitor with anticoagulant properties, were performed wherein the properties of the full-length antistasin polypeptide (ATS-119) were compared with the properties of forms of antistasin truncated at residue 116 (ATS-116) and residue 112 (ATS-112). ATS-119 was 40-fold more potent than ATS-112 in prolonging the activated partial thromboplastin time (APTT), whereas ATS-119 inhibited factor Xa 2.2-fold less avidly and about 5-fold more slowly than did ATS-112. The decreased reactivity of ATS-119 suggests that the carboxyl-terminal domain of ATS-119 stabilizes an ATS conformation with a reduced reactivity toward factor Xa. The observation that calcium ion increases the reactivity of ATS-119 but not that of ATS-112 suggests that calcium ion may disrupt interactions involving the carboxyl terminus of ATS-119. Interestingly, ATS-119 inhibited factor Xa in the prothrombinase complex 2-6-fold more potently and 2-3-fold faster than ATS-112. These differences in affinity and reactivity might well account for the greater effectiveness of ATS-119 in prolonging the APTT and suggest that the carboxyl-terminal domain of ATS-119 disrupts interactions involving phospholipid, factor Va, and prothrombin in the prothrombinase complex. The peptide RPKRKLIPRLS, corresponding to the carboxyl domain of ATS-119 prolonged the APTT and inhibited prothrombinase-catalyzed processing of prothrombin, but it failed to inhibit the catalytic activity of isolated factor Xa. Thus, this novel inhibitor appears to exert its inhibitory effects at a site removed from the active site of factor Xa.Factor Xa (fXa), 1 a serine protease that functions at the intersection of the intrinsic and extrinsic pathway for blood coagulation, activates prothrombin to thrombin. Thrombin in turn activates platelets and converts the soluble plasma protein fibrinogen to the insoluble fibrin matrix of blood clots. The central role of fXa in blood coagulation suggests that fXa inhibitors might have therapeutic utility as anticoagulants. It is important to note, however, that fXa functions in the blood coagulation cascade in a complex with calcium ion, factor Va (fVa) and an appropriate phospholipid membrane, and that the catalytic activity toward prothrombin of this prothrombinase complex is several orders of magnitude greater than that of isolated fXa (1, 2). These observations suggest that certain inhibitors might exhibit different inhibitory potencies toward fXa in the prothrombinase complex and isolated fXa.