This review discusses the recent advancements and challenges in the use of mesenchymal stem cells (MSCs) for cell therapy. MSCs, which have been used clinically for about 10 years, have shown promise in treating various diseases, particularly tissue injuries and immune disorders. The review covers methods, timing, and sources for MSC administration in clinical applications, as well as the mechanisms underlying MSC-mediated therapies. Despite the safety and effectiveness of MSCs, several challenges remain, including optimizing dosage, routes of administration, engraftment time, and monitoring clinical effectiveness. The review also highlights the importance of understanding the homing efficiency of MSCs, their differentiation potential, trophic factor production, and immunomodulatory effects. While significant progress has been made, further research is needed to establish standardized protocols and regulatory guidelines for the widespread use of MSCs in clinical settings.This review discusses the recent advancements and challenges in the use of mesenchymal stem cells (MSCs) for cell therapy. MSCs, which have been used clinically for about 10 years, have shown promise in treating various diseases, particularly tissue injuries and immune disorders. The review covers methods, timing, and sources for MSC administration in clinical applications, as well as the mechanisms underlying MSC-mediated therapies. Despite the safety and effectiveness of MSCs, several challenges remain, including optimizing dosage, routes of administration, engraftment time, and monitoring clinical effectiveness. The review also highlights the importance of understanding the homing efficiency of MSCs, their differentiation potential, trophic factor production, and immunomodulatory effects. While significant progress has been made, further research is needed to establish standardized protocols and regulatory guidelines for the widespread use of MSCs in clinical settings.