Factor Xa is the active form of prothrombin in the clotting process, belonging to the serineprotease family. It cleaves prothrombin to form thrombin, initiating fibrin formation, and is a key enzyme in coagulation and hemostasis. Factor Xa is generated and activated in plasma, and its activity is co-regulated by coagulation factors Va, Ca2+, and phospholipid surfaces. Specific gene expression and genetic mutations influence its activity, potentially leading to bleeding or thrombotic tendencies. Therefore, Factor Xa inhibitors are used to prevent and treat thrombotic diseases, demonstrating their crucial role in maintaining blood homeostasis and managing diseases.