Organoids are crucial for tissue repair and biofunctional reconstruction, offering a more effective alternative to traditional therapies. This review discusses the development of engineered organoids, their applications in tissue regeneration, and the challenges in clinical translation. Organoids, derived from stem cells or primary tissues, mimic the structure and function of organs, providing a platform for studying disease and drug development. However, conventional methods have limited their clinical application. Bioengineering has enabled the development of engineered organoids, enhancing reproducibility, control, and efficiency. These organoids can be used to treat various diseases affecting the brain, skin, bone, liver, and endocrine glands. Despite their potential, challenges such as limited differentiation capacity, tumorigenicity, and ethical concerns remain. Advances in bioengineering, including microwell arrays, bioreactors, microfluidics, bioprinting, and hydrogel matrices, have improved organoid culture and maturation. These technologies allow for precise control over organoid development, enabling the creation of complex, functional organoids. The integration of genetic engineering, such as CRISPR-Cas9, has further enhanced organoid functionality. While challenges persist, the future of organoid engineering holds promise for personalized tissue repair and biofunctional reconstruction.Organoids are crucial for tissue repair and biofunctional reconstruction, offering a more effective alternative to traditional therapies. This review discusses the development of engineered organoids, their applications in tissue regeneration, and the challenges in clinical translation. Organoids, derived from stem cells or primary tissues, mimic the structure and function of organs, providing a platform for studying disease and drug development. However, conventional methods have limited their clinical application. Bioengineering has enabled the development of engineered organoids, enhancing reproducibility, control, and efficiency. These organoids can be used to treat various diseases affecting the brain, skin, bone, liver, and endocrine glands. Despite their potential, challenges such as limited differentiation capacity, tumorigenicity, and ethical concerns remain. Advances in bioengineering, including microwell arrays, bioreactors, microfluidics, bioprinting, and hydrogel matrices, have improved organoid culture and maturation. These technologies allow for precise control over organoid development, enabling the creation of complex, functional organoids. The integration of genetic engineering, such as CRISPR-Cas9, has further enhanced organoid functionality. While challenges persist, the future of organoid engineering holds promise for personalized tissue repair and biofunctional reconstruction.