The complex of the cell surface receptor tissue factor (TF) and its ligand coagulation factor VIIa (FVIIa) is the primary initiator of the coagulation cascade. It is now clear the TF-initiated coagulation pathway also plays major nonhemostatic roles in inflammation, tumor growth, and angiogenesis. Direct or indirect cell signaling by TF-FVIIa or downstream coagulation proteases is an essential part of these nonhemostatic functions. The TF-FVIIa complex activates protease-activated receptor 2 and thus regulates gene transcription and protein translation, cell proliferation and survival, or cell motility and integrin activation. In this review, we relate our current understanding of direct TF signaling pathways to the emerging roles of TF in (patho) physiology.