Articular cartilage injury is a prevalent global health issue, and effective treatments are urgently needed due to the limited self-repair ability of cartilage. Despite various clinical treatments, unfavorable outcomes and complications remain common. The advent of tissue engineering and regenerative medicine has led to increased interest in using biomaterials for articular cartilage repair. This review provides an overview of primary biomaterials and bioactive substances from a tissue engineering perspective, focusing on regeneration, substitution, and immunization strategies. It highlights the influence of mechanically supportive scaffolds on cellular behavior and emerging scaffold technologies, including stimuli-responsive smart scaffolds, 3D-printed scaffolds, and cartilage bionic scaffolds. The role of biologically active substances, such as bioactive factors, stem cells, extracellular vesicles (EVs), and cartilage organoids, in regulating chondrocyte activity is also discussed. Additionally, the review presents commercially available composite bioactive scaffolds for clinical use, offering innovative solutions for treating articular cartilage ailments and emphasizing the potential of biomaterials in clinical translation.Articular cartilage injury is a prevalent global health issue, and effective treatments are urgently needed due to the limited self-repair ability of cartilage. Despite various clinical treatments, unfavorable outcomes and complications remain common. The advent of tissue engineering and regenerative medicine has led to increased interest in using biomaterials for articular cartilage repair. This review provides an overview of primary biomaterials and bioactive substances from a tissue engineering perspective, focusing on regeneration, substitution, and immunization strategies. It highlights the influence of mechanically supportive scaffolds on cellular behavior and emerging scaffold technologies, including stimuli-responsive smart scaffolds, 3D-printed scaffolds, and cartilage bionic scaffolds. The role of biologically active substances, such as bioactive factors, stem cells, extracellular vesicles (EVs), and cartilage organoids, in regulating chondrocyte activity is also discussed. Additionally, the review presents commercially available composite bioactive scaffolds for clinical use, offering innovative solutions for treating articular cartilage ailments and emphasizing the potential of biomaterials in clinical translation.