It's NT's syscall translation layer, CPU mode switching backend and entry point front end. It was originally used to run 16-bit apps on 32-bit platforms but is now WOW64 so is to run 32-bit apps on 64-bit machines.
Basically it's a very light weight virtualisation layer.
And it works well. My circa 1996 RPN calculator I wrote in VC++ works perfectly on 2013 x64 machine.