Aim To investigate the effect of tissue factor pathway inhibitor （TFPI） gene transfer on the expression of inhibitor of apoptosis proteins（IAP） in vascular smooth muscle cell （VSMC）. Methods Human TFPI or LacZ recombinant adenovirus or DMEM was used to infect rat aortic VSMC in vitro respectively. ELISA was used to examine the expression of exogenous TFPI gene. RT-PCR was used to detect the expression of c-IAP1mRNA and western blot was used to detect the expression of survivin at different time points after gene transfer. Results TFPI protein expression was detected in VSMC at 1st day after gene transfer and the peak expression was at the 3rd day. The expression of c-IAP1mRNA in TFPI group was reduced compared with those in the LacZ and DMEM groups （P<0.05）. The expression of survivin in TFPI group was also decreased compared with those in LacZ and DMEM groups （P<0.05） in a time dependent manner. Conclusions TFPI might induce VSMC apoptosis through the inhibition on the expression of IAP,and therefore reduce the occurrence of restenosis after percutaneous coronary intervention.