As a member of the ubiquitin-like protein family, the human leukocyte antigen F locus adjacent transcript 10 is composed of two ubiquitin-like domains that have high homology with ubiquitin. Studies have shown that abnormal FAT10 expression and FAT10ylation are crucial to many aspects of cellular biology, such as protein degradation, immune response, regulation of apoptosis and cell cycle progression. In this manuscript, we review some important biological roles of FAT10 in cardioprotection and tumor promotion. FAT10 may be cardioprotective in ischemia and hypoxia through attenuation of hypoxi...