Poly(methyl methacrylate) (PMMA) is widely used in orthopedic applications, including bone cement for joint replacement surgery, bone fillers, and bone substitutes due to its affordability, biocompatibility, and processability. However, PMMA's lack of bioactivity, poor osseointegration, and non-degradability limit its effectiveness in bone regeneration. To address these issues, various strategies have been developed, such as surface modification techniques and the incorporation of bioactive agents and biopolymers into PMMA. This review discusses the physicochemical properties and synthesis methods of PMMA, with a focus on its use in bone tissue engineering. It also explores the challenges of integrating PMMA into regenerative medicine and provides insights to support its clinical applications. PMMA is a synthetic polymer with excellent mechanical properties, including high impact strength, compressive strength, and tensile strength. It has a high glass transition temperature and is resistant to sunlight and thermal degradation. PMMA can be synthesized using various polymerization methods, including free-radical polymerization, RAFT, ATRP, anionic polymerization, and coordination polymerization. These methods allow for the production of PMMA with controlled molecular weight and narrow weight distribution. PMMA is used in biomedical applications such as bone cement, which is used to affix prosthetic devices to bones. However, PMMA bone cement has drawbacks, including high exothermic temperature during polymerization, which can cause thermal necrosis, and the release of methyl methacrylate (MMA), which can be toxic to surrounding tissues. To improve the bioactivity and osseointegration of PMMA, researchers have incorporated bioactive agents such as hydroxyapatite (HAp), carbon nanotubes, and natural polymers like chitosan and collagen. These modifications enhance the biological activity of PMMA and improve its integration with bone tissue. PMMA nanofibers and 3D scaffolds are also being explored for bone tissue engineering. These structures offer high porosity, large surface area, and a structure that mimics the natural extracellular matrix, making them suitable for promoting bone tissue growth and regeneration. PMMA-based scaffolds can be tailored to meet individual patient requirements, providing better support for tissue regeneration compared to traditional bone cement. In conclusion, PMMA has significant potential in bone tissue engineering, but its limitations in bioactivity and osseointegration require further research and development. By incorporating bioactive agents and modifying the surface of PMMA, researchers aim to enhance its performance in clinical applications. The integration of PMMA with other materials and the development of advanced fabrication techniques are key to overcoming the challenges associated with PMMA in bone tissue engineering.Poly(methyl methacrylate) (PMMA) is widely used in orthopedic applications, including bone cement for joint replacement surgery, bone fillers, and bone substitutes due to its affordability, biocompatibility, and processability. However, PMMA's lack of bioactivity, poor osseointegration, and non-degradability limit its effectiveness in bone regeneration. To address these issues, various strategies have been developed, such as surface modification techniques and the incorporation of bioactive agents and biopolymers into PMMA. This review discusses the physicochemical properties and synthesis methods of PMMA, with a focus on its use in bone tissue engineering. It also explores the challenges of integrating PMMA into regenerative medicine and provides insights to support its clinical applications. PMMA is a synthetic polymer with excellent mechanical properties, including high impact strength, compressive strength, and tensile strength. It has a high glass transition temperature and is resistant to sunlight and thermal degradation. PMMA can be synthesized using various polymerization methods, including free-radical polymerization, RAFT, ATRP, anionic polymerization, and coordination polymerization. These methods allow for the production of PMMA with controlled molecular weight and narrow weight distribution. PMMA is used in biomedical applications such as bone cement, which is used to affix prosthetic devices to bones. However, PMMA bone cement has drawbacks, including high exothermic temperature during polymerization, which can cause thermal necrosis, and the release of methyl methacrylate (MMA), which can be toxic to surrounding tissues. To improve the bioactivity and osseointegration of PMMA, researchers have incorporated bioactive agents such as hydroxyapatite (HAp), carbon nanotubes, and natural polymers like chitosan and collagen. These modifications enhance the biological activity of PMMA and improve its integration with bone tissue. PMMA nanofibers and 3D scaffolds are also being explored for bone tissue engineering. These structures offer high porosity, large surface area, and a structure that mimics the natural extracellular matrix, making them suitable for promoting bone tissue growth and regeneration. PMMA-based scaffolds can be tailored to meet individual patient requirements, providing better support for tissue regeneration compared to traditional bone cement. In conclusion, PMMA has significant potential in bone tissue engineering, but its limitations in bioactivity and osseointegration require further research and development. By incorporating bioactive agents and modifying the surface of PMMA, researchers aim to enhance its performance in clinical applications. The integration of PMMA with other materials and the development of advanced fabrication techniques are key to overcoming the challenges associated with PMMA in bone tissue engineering.