Bone marrow stromal/stem cells (BMSCs) are multipotent adult stem cells and have become the important cell source for cell therapy and engineered tissue repair. Their osteogenic differentiation potential has been well characterized in many in vitro studies. In addition, small animal model-based studies also reveal their capability of bone formation in vivo when implanted with biodegradable scaffold, indicating the great potential for therapeutic application. Bone defect is a common clinical problem that deserves an optimal therapy. Unlike traditional surgical repair that needs to sacrifice donor site tissue, the tissue-engineering approach can achieve the goal of bone regeneration and repair without the necessity of donor site morbidity. To safely translate experimental study into a clinical trial of engineered bone repair, in vivo study using large animal models has become the key issue. Our in vivo study in this aspect and the published results indicate that bone regeneration and repair by BMSCs and biodegradable scaffold is a realistic goal that can be achieved.