Thrombus-related diseases are cardiovascular diseases with extremely high mortality worldwide.Although existing traditional antithrombotic drugs in clinical practice can effectively inhibit thrombus progression,they are generally associated with problems such as high bleeding risk and numerous adverse reactions, which limit their safe application. Therefore, there is an urgent need to develop new treatment strategies with better efficacy and higher safety. Antithrombotic active peptides have obvious advantages over traditional chemical drugs due to their wide range of sources, low molecular weight, low immunogenicity and multi-target synergistic effects, thus demonstrating prominent industrialization potential. This paper summarized and organized the research progress of antithrombotic active peptides derived from animals, plants, marine organisms and microorganisms, and clarified the material and structural basis for their anticoagulant function. Meanwhile, it summarized the optimization methods of enzymatic hydrolysis, microbial fermentation, chemical synthesis and bioinformatics-assisted screening in peptide preparation, as well as the efficient application of uitrafiltration and liquid chromatography-mass spectrometry in the separation, purification and sequence identification of active peptides. Studies on the mechanism of action indicate that antithrombotic active peptides can inhibit thrombosis through multiple pathways, mainly by means of active site competitive inhibition, Exosite targeted regulation and blocking of the coagulation factor cascade reaction. However,there are still key bottlenecks in the clinical transformation of antithrombotic active peptides, including insufficient in vivo metabolic stability, high industrial production costs and inadequate analysis of the multi-target synergistic mechanism. Based on the above research results, future studies shall focus on the design of targeted peptide drugs, the development of strategies to improve metabolic stability, and the innovation of large-scale production technologies,so as to provide theoretical support for breaking through existing clinical difficulties and developing high-efficiency and low-toxicity antithrombotic drugs.