There has been an intense and competitive quest to manufacture bioartificial heart muscle in the last decade. Numerous biocompatible scaffolds and scaffold-free systems, enriched with various cell types, have been used to fabricate 3D grafts for myocardial repair. In spite of the impressive achievements in the myocardial tissue-engineering field, many issues remain to be addressed before clinical application of this strategy becomes feasible. This is largely due to the uniqueness of the heart's structure and function. This review provides a survey upon the reported strategies, and indicates caveats and perspectives in the field of myocardial tissue engineering.