The endometrium, a highly dynamic tissue, undergoes cyclic regeneration to prepare for embryo implantation. However, disruptions in this process can lead to infertility due to endometrial scarring or thin endometrium. Mesenchymal stem cells (MSCs), multipotent adult stem cells, have shown potential in treating these conditions. MSCs can differentiate into various cell types and secrete bioactive factors that promote tissue repair and regeneration. Studies in rodent models and limited human trials have demonstrated the benefits of MSCs in treating endometrial infertility. The review explores the mechanisms by which MSCs promote regeneration and repair, including their homing properties, secretome, and immune modulation. Key findings include improved endometrial thickness, gland number, angiogenesis, and reduced fibrosis in response to MSC treatment. Human in vitro studies further validate the paracrine mechanisms by which MSCs mediate endometrial repair. Overall, the therapeutic potential of MSCs in treating impaired endometrial receptivity due to thin endometrium or endometrial scarring is promising, with ongoing research aiming to optimize delivery methods and efficacy.The endometrium, a highly dynamic tissue, undergoes cyclic regeneration to prepare for embryo implantation. However, disruptions in this process can lead to infertility due to endometrial scarring or thin endometrium. Mesenchymal stem cells (MSCs), multipotent adult stem cells, have shown potential in treating these conditions. MSCs can differentiate into various cell types and secrete bioactive factors that promote tissue repair and regeneration. Studies in rodent models and limited human trials have demonstrated the benefits of MSCs in treating endometrial infertility. The review explores the mechanisms by which MSCs promote regeneration and repair, including their homing properties, secretome, and immune modulation. Key findings include improved endometrial thickness, gland number, angiogenesis, and reduced fibrosis in response to MSC treatment. Human in vitro studies further validate the paracrine mechanisms by which MSCs mediate endometrial repair. Overall, the therapeutic potential of MSCs in treating impaired endometrial receptivity due to thin endometrium or endometrial scarring is promising, with ongoing research aiming to optimize delivery methods and efficacy.