BACKGROUND CONTEXT: One of the most promising therapies for symptomatic disc degeneration involves the implantation of therapeutic cells into the degenerative disc. PURPOSE: In this article, the rationale and approaches for cell-based tissue engineering of the intervertebral disc are discussed. STUDY DESIGN: The scientific literature related to cell-based tissue engineering of the intervertebral disc is reviewed. METHODS: A variety of cell types have been used in various research models to affect matrix repair of the intervertebral disc. The use of cellular scaffolds and growth factors or genes also appears promising for achieving meaningful tissue repair of the intervertebral disc. RESULTS: Disc tissue engineering is a promising approach for achieving repair of the intervertebral disc. Using cell-based approaches, various research models suggest that improvements in the complex matrix of the disc may be achieved. CONCLUSION: A cell-based approach to repair of the intervertebral disc appears promising. More research is needed to define the optimal cell type, cellular scaffold and mixture of growth factors that may allow meaningful repair of the human symptomatic degenerative disc.