Abstract: A large number of epidemiological and toxicological studies have proved that atmospheric particulate matter (PM) exposure is closely related to the prevalence of cardiovascular disease, but the specific biological mechanism is still unclear. It is currently speculated that it may be related to blood coagulation caused by inhaled PM. Blood coagulation is an important mechanism for the development of cardiovascular diseases and is associated with a variety of thrombotic diseases. This article focuses on the key role of coagulation cascade activation in the procoagulant effect of PM, and mainly reviews the current research progress on the activation of extrinsic and intrinsic coagulation cascade pathways after exposure to PM. The results show that: (1) Exposure to PM can activate the coagulation cascade, which in turn induces coagulation effects such as blood clots formation, fibrinolysis inhibition and platelet activation. (2) The impact of PM exposure on extrinsic pathways is mainly manifested as increased expression of tissue factor (TF). (3) FⅫ can be activated by contact with the surface of PM, then induce a large amount of thrombin generation and activate the intrinsic coagulation cascade. Studies have shown that the activation of the coagulation cascade is one of the important mechanisms for PM induced cardiovascular disease.