4-Oxo Ticlopidine is a major active metabolite of ticlopidine, an antiplatelet agent. It plays a crucial role in inhibiting platelet aggregation by irreversibly blocking the P2Y12 subtype of adenosine diphosphate (ADP) receptors on platelet surfaces. This action prevents ADP-mediated activation of the glycoprotein IIb/IIIa complex, which is essential for platelet cross-linking and thrombus formation. Due to its potent antiplatelet effects, 4-Oxo Ticlopidine contributes significantly to the prevention of arterial thrombosis. It is particularly used in reducing the risk of stroke and transient ischemic attacks in patients with a history of cerebrovascular events. It is also employed in patients undergoing coronary stent placement to prevent stent thrombosis, especially when aspirin is not sufficient or tolerated. The compound’s activity supports its parent drug’s therapeutic efficacy, making it valuable in cardiovascular medicine. However, due to risks of hematological side effects associated with ticlopidine metabolism, monitoring is required during treatment.