We have previously shown that the C-terminus of TFPI is essential for its anticoagulant activity. In the present study we have assessed the role of this region in the binding of TFPI to lipoproteins. We found that full length TFPI, but not C-terminal degraded TFPI, was capable of coeluting with the plasma lipoprotein fraction on a Superose-6 column. The importance of the TFPI C-terminus in lipoprotein interactions was also assessed using a microtitre plate binding assay. We found that full-length TFPI was capable of binding to VLDL or LDL coated microtitre plates. C-terminal degraded TFPI also bound to VLDL, but with a ten-fold lower affinity than full length TFPI. Interestingly, removal of the C-terminus along with the third Kunitz-type domain resulted in a TFPI form incapable of lipoprotein binding. Since heparin shows strong binding to the C-terminus of TFPI, we also tested its effect on the binding of full length TFPI to VLDL. We found that co-incubation of TFPI with heparin inhibited this binding in a dose-dependent manner. Heparin was also capable of releasing TFPI from a preformed TFPI:VLDL complex, although this reaction required unphysiological amounts of heparin. To assess the physiological function of heparin on FL-TFPI:lipoprotein interactions we also performed gel filtration chromatography of rabbit plasma immediately following i.v. administration of FL-TFPI with and without heparin. Previous experiments indicated that heparin has a protective effect on exogenously added FL-TFPI, increasing its recovery by ten-fold. We found that FL-TFPI remaining in circulation 5 min after administration migrates solely in high molecular weight fractions, whereas the TFPI recovered after co-injection of heparin migrates solely in the low molecular weight fractions. Collectively our results indicate that the C-terminus of TFPI is involved in lipoprotein binding, and that binding of TFPI to lipoproteins and glycosaminoglycans may be related phenomena.