Human thymidylate synthase (hTS) is an established anticancer target. It catalyses the production of 2'-deoxythymidine-5'-monophosphate, an essential building block for DNA synthesis. Because of the development of cellular drug resistance against current hTS inhibitors, alternative inhibition strategies are needed. hTS exists in two forms, active and inactive, defined by the conformation of the active-site (AS) loop, which carries the catalytic cysteine, C195. To investigate the mechanism of activation and inactivation, targeted molecular dynamics (TMD) simulations of the transitions between active and inactive states of hTS were performed. Analysis of changes in the dihedral angles in the AS loop during different TMD simulations revealed complex conformational transitions. Despite hTS being a homodimeric enzyme and the conformational transition significantly involving the dimer interface, the transition occurs in an asymmetric, sequential manner via an ensemble of pathways. In addition to C195, which reoriented during the simulations, other key residues in the rotation of the AS loop included W182 and R185. The interactions of the cognate bulky W182 residues at the dimer interface hindered the simultaneous twist of the AS loops in the hTS dimer. Interactions of R185, which is unique for hTS, with ligands at different allosteric sites affected the activation transition. In addition to providing insights into the activation/inactivation mechanism of hTS and how conformational transitions can occur in homodimeric proteins, our observations suggest that blocking of AS loop rotation by ligands binding in the large cavity between the loops could be one way to stabilize inactive hTS and inhibit the enzyme.