A tissue fastening apparatus related to the present invention includes；a tissue fastening tool (10A) formed of a wire wound into a coil shape provided with a first tissue fixing section (11) which is hooked onto a first biological tissue and a second tissue fixing section (12) which is hooked onto a second biological tissue； a tubular puncturing tool (52) which extends a tissue fastening tool (10A) and accommodates the stretched tissue fastening tool (10A) inside of the puncturing tool (52)； a fastening tool pusher in which the distal end thereof is inserted into the puncturing tool (52) and dispenses the tissue fastening tool (10A) inserted into the puncturing tool (52) from a distal end of the puncturing tool (52) when the fastening tool pusher (53) advances； and a rotating mechanism (96) to rotate the puncturing tool (52) when the fastening tool pusher (53) advances.
