Cardiovascular diseases are the leading cause of morbidity and mortality. Tissue engineering offers new option in the myocardial repair techniques. The cellular component of this regenerative approach will play a key role in bringing these tissue engineered constructs from the laboratory bench to the clinical bedside. However, the ideal source of cells still remains unclear and may differ depending upon the application. Current research for many applications is focused on the use of stem cells. The combination of stem cell technology and tissue engineering has been investigated and offers promising avenues for myocardial tissue regeneration, and this shows great promise in future reconstructive surgery. We explore the basic concepts and methods for myocardial tissue reconstruction and emphasize the progress made and remaining challenges of stem cells in myocardial tissue engineering.