Follistatin related protein (FRP) is an extra-cellular glycoprotein, involved in several pathological and physiological processes such as cell proliferation, migration, tissue remodeling, embryonic development, and cell-cell interaction. Nowadays researches showed that FRP possesses dual functions, including inhibiting cell apoptosis and inhibiting cell proliferation. In myocardial ischemia model, FRP is certified to have the effect of protecting myocardial cell and inhibiting apoptosis. At the same time FRP promotes endothelial cell proliferation. FRP is also synthesized by vascular smooth muscle cell (VSMC) to regulate the functions of VSMC via feedback mechanism. FRP can induce apoptosis in various cancer cell lines. In this review, we summarized the up-to-date data to show the structure, functions, mechanisms and regulation pathways of the protein.