Matriptase (also known as MT-SP1, ST14, prostamin and epithin in mouse) is a tumor-associated type II transmembrane serine protease that is highly expressed in many human cancer-derived cell lines and is implicated in extracellular matrix re-modeling, tumor growth, and metastasis. Matriptase performs pleiotropic functions in the development of the epidermis, hair follicles, and cellular immune system. Sphingosine 1-phosphate (S1P, SPP), present in serum-derived lipoproteins, activates matriptase while matriptase activates both urokinase-type plasminogen activator and hepatocyte growth factor (HGF). Hepatocyte growth factor activator inhibitor type 1 (HAI-1) is a Kunitz-type serine protease inhibitor identified as a strong inhibitor of matriptase and HGF. Advanced-stage ovarian tumors that express matriptase are more likely to do so in the absence of its inhibitor, HAI-1, indicating that an imbalance in the matriptase: HAI-1 ratio could be important in the development of advanced disease.