胸苷酸合成酶利用5,10-亚甲基四氢叶酸（亚甲基四氢叶酸）作为辅因子催化脱氧尿苷酸甲基化为脱氧胸苷酸。此功能维持DNA复制和修复的关键DTMP（胸腺嘧啶-5-一磷酸素）池。这种酶作为肿瘤化疗药物的靶点一直备受关注。它被认为是5-氟尿嘧啶、5-氟尿嘧啶-2-原脱氧尿苷和一些叶酸类似物的主要作用部位。该基因和自然产生的反义转录本rtsalpha（geneid:55556）的表达在细胞生长从晚期对数阶段向平稳期呈负向变化。
Thymidylate synthase catalyzes the methylation of deoxyuridylate to deoxythymidylate using 5,10-methylenetetrahydrofolate (methylene-THF) as a cofactor. This function maintains the dTMP (thymidine-5-prime monophosphate) pool critical for DNA replication and repair. The enzyme has been of interest as a target for cancer chemotherapeutic agents. It is considered to be the primary site of action for 5-fluorouracil, 5-fluoro-2-prime-deoxyuridine, and some folate analogs. Expression of this gene and that of a naturally occuring antisense transcript rTSalpha (GeneID:55556) vary inversely when cell-growth progresses from late-log to plateau phase.