Chimeric antigen receptor T cell therapy revolutionizes the field of cancer immunotherapy and has been increasingly utilized in a variety of oncological settings with success. However, it is associated with the occurrence of cytokine release syndrome where a cytokine storm triggered by chimeric antigen receptor (CAR) T cell infusion causes multiorgan dysfunction and mortality. Among the serious consequences of cytokine release syndrome, coagulopathies induced by abnormal endothelial regulatory mechanisms, dysfunction of platelet aggregation, and activation represent one of the key challenges faced by clinicians, and an understanding of the underlying drivers of coagulopathies is crucial to the prompt discovery and management of the consequences. A review of CAR T cell therapy, its associated cytokine release syndrome, and the inflammatory and thrombogenic processes involved are highlighted, with a key emphasis on the relationships of mechanisms behind cytokine release syndrome, early recognition and management of cytokine release syndrome, and mechanisms and management of coagulopathies in the context of inflammation and thrombosis. Given the severity of cytokine release syndrome and its associated coagulopathies, close, regular monitoring and prompt therapeutic interventions are key to reducing morbidity and mortality in recipients of CAR T cell treatment.