The knee meniscus is a vital structure in the knee joint, playing a key role in preventing articular cartilage degradation and the development of osteoarthritis. Recent research has focused on meniscus repair and regeneration, with current techniques primarily targeting the vascularized peripheral region, while the avascular inner region remains challenging to treat. Partial meniscectomy, though commonly used, often leads to progressive osteoarthritis, prompting interest in tissue engineering and biomaterials. Various approaches have contributed to the in vitro generation of meniscus constructs, capable of restoring lesions functionally and anatomically. The selection of cell sources (autologous, allogeneic, xenogeneic, or stem cells) is critical for successful tissue engineering. A wide range of scaffolds have been proposed, though issues like degradation byproducts and stress shielding have led to new strategies such as scaffoldless approaches and self-assembly. Chemical and mechanical stimuli, including TGF-β1, C-ABC, direct compression, and hydrostatic pressure, have been investigated to promote tissue formation and stem cell differentiation. Despite challenges, recent advances in biology, engineering, and medicine are paving the way for successful meniscal lesion treatment. The meniscus has distinct anatomical and biochemical characteristics, with the outer vascular region (red-red zone) and inner avascular region (white-white zone) differing in structure and function. The meniscus is composed of collagen, proteoglycans, and adhesion glycoproteins, with collagen type I and II being predominant in different regions. Meniscus cells vary in morphology and function, with outer zone cells resembling fibroblasts and inner zone cells resembling fibrochondrocytes. The meniscus plays a crucial role in load-bearing, shock absorption, and lubrication of articular cartilage. Meniscal tears are common in young and older individuals, with different etiologies and pathologies. Repair techniques for peripheral tears include inside-out, outside-in, and all-inside arthroscopic methods, while avascular tears remain challenging. Allogeneic and xenogeneic cells, as well as stem cells, have been explored for meniscus regeneration. Synthetic polymer scaffolds, hydrogels, and ECM-derived materials are being investigated for their potential in meniscus tissue engineering. These scaffolds must possess appropriate mechanical properties, bioactivity, and logistics for successful integration with host tissue. Recent advances in scaffold design, including aligned and woven structures, have improved mechanical properties and anisotropy. Hydrogels offer versatility and can be functionalized for cell adhesion and matrix synthesis. However, challenges remain in achieving the mechanical strength and bioactivity required for meniscus regeneration. Overall, tissue engineering holds promise for the regeneration of meniscal tissue, with ongoing research aimed at improving scaffold design and cell sources for effective meniscus repair.The knee meniscus is a vital structure in the knee joint, playing a key role in preventing articular cartilage degradation and the development of osteoarthritis. Recent research has focused on meniscus repair and regeneration, with current techniques primarily targeting the vascularized peripheral region, while the avascular inner region remains challenging to treat. Partial meniscectomy, though commonly used, often leads to progressive osteoarthritis, prompting interest in tissue engineering and biomaterials. Various approaches have contributed to the in vitro generation of meniscus constructs, capable of restoring lesions functionally and anatomically. The selection of cell sources (autologous, allogeneic, xenogeneic, or stem cells) is critical for successful tissue engineering. A wide range of scaffolds have been proposed, though issues like degradation byproducts and stress shielding have led to new strategies such as scaffoldless approaches and self-assembly. Chemical and mechanical stimuli, including TGF-β1, C-ABC, direct compression, and hydrostatic pressure, have been investigated to promote tissue formation and stem cell differentiation. Despite challenges, recent advances in biology, engineering, and medicine are paving the way for successful meniscal lesion treatment. The meniscus has distinct anatomical and biochemical characteristics, with the outer vascular region (red-red zone) and inner avascular region (white-white zone) differing in structure and function. The meniscus is composed of collagen, proteoglycans, and adhesion glycoproteins, with collagen type I and II being predominant in different regions. Meniscus cells vary in morphology and function, with outer zone cells resembling fibroblasts and inner zone cells resembling fibrochondrocytes. The meniscus plays a crucial role in load-bearing, shock absorption, and lubrication of articular cartilage. Meniscal tears are common in young and older individuals, with different etiologies and pathologies. Repair techniques for peripheral tears include inside-out, outside-in, and all-inside arthroscopic methods, while avascular tears remain challenging. Allogeneic and xenogeneic cells, as well as stem cells, have been explored for meniscus regeneration. Synthetic polymer scaffolds, hydrogels, and ECM-derived materials are being investigated for their potential in meniscus tissue engineering. These scaffolds must possess appropriate mechanical properties, bioactivity, and logistics for successful integration with host tissue. Recent advances in scaffold design, including aligned and woven structures, have improved mechanical properties and anisotropy. Hydrogels offer versatility and can be functionalized for cell adhesion and matrix synthesis. However, challenges remain in achieving the mechanical strength and bioactivity required for meniscus regeneration. Overall, tissue engineering holds promise for the regeneration of meniscal tissue, with ongoing research aimed at improving scaffold design and cell sources for effective meniscus repair.