Alternative splicing is an important mechanism for modulating gene function that accounts for a considerable proportion of proteomic complexity in higher eukaryotes. Alternative splicing is often tightly regulated in a cell-type- or developmental-stage- specific manner and can cause a single gene to have multiple functions. Human Tissue transglutaminase (TGM2) is a multifunctional enzyme with transglutaminase crosslinking (TGase), G protein signaling and kinase activities that are postulated to play a role in many disease states. TGM2 mRNA is regulated by alternative splicing, producing C-terminal truncated forms of TGM2 that are predicted to have distinct biochemical properties and biological functions. In this review, we will discuss how alternatively spliced forms of TGM2 could modulate its roles in cancer, neurodegeneration, inflammation and wound healing.