The treatment of full thickness articular defects remains a challenging problem for the orthopaedic surgeon. Beside bone marrow stimulation techniques (microfractures) and autologous osteochondral mosaicplasty, a variety of procedures have been proposed to promote the healing of articular lesions by cultured competent cells. Tissue engineering is an emerging field, whose goal is to repair or replace tissues and organs by delivering the appropriate cells, biomaterials and signaling factors to diseased or damaged areas. In this article, we review the preclinical and clinical literature reported on the fabrication of implantable cartilage structures from chondrocytes and mesenchymal stem cells and discuss potential areas of development in the field of cartilage repair. Before routine use of engineered cartilage grafts in the clinic, the safety and efficacy of these therapies need to be validated in prospective human clinical trials.