Annexins, a family of highly conserved calcium- and phospholipid-binding proteins, play important roles in a wide range of physiologic functions. Among the 12 known annexins in humans, annexin A2 (AnxA2) is one of the most extensively studied and has been implicated in various human diseases. AnxA2 can exist as a monomer or a heterotetrameric complex with S100A10 (P11) and plays a critical role in many cellular processes, including exocytosis, endocytosis, and membrane organization. At the endothelial cell surface, the (AnxA2⋅P11) tetramer-acting as a coreceptor for plasminogen and tissue plasminogen activator (tPA)-accelerates tPA-dependent activation of the fibrinolytic protease, plasmin, the enzyme that is responsible for thrombus dissolution and the degradation of fibrin. This study demonstrates that EPAC1 (exchange proteins directly activated by cAMP isoform 1) interacts with AnxA2 and regulates its biologic functions by modulating its membrane translocation in endothelial cells. By using genetic and pharmacologic approaches, we demonstrate that EPAC1-acting via the PLCε-PKC pathway-inhibits AnxA2 surface translocation and plasminogen activation. These results suggest that EPAC1 plays a role in the regulation of fibrinolysis in endothelial cells and may represent a novel therapeutic target for disorders of fibrinolysis.-Yang, W., Mei, F. C., Cheng, X. EPAC1 regulates endothelial annexin A2 cell surface translocation and plasminogen activation.