The most important factors in the tissue engineering approach to tissue repair and regeneration are the use of appropriate cells and scaffolds. Mesenchymal stem cells (MSCs) are one of the most promising seed cells, which can be easily derived and have the potential to differentiate into various mesenchymal cell types as well as tenocytes in vitro and in vivo. Biological tendon grafts are the most common choice in current clinical practice, as they possess physical structure, strength and biocompatibility. We review the latest research findings on MSC-based tendon tissue engineering and recent advances in biological graft research.