Mesenchymal stem cells are known as being multipotent and exhibit the potential for differentiation into different cells/tissue lineages, including cartilage, bone, adipose tissue, tendon, and ligament. These pluripotent mesenchymal progenitor cells are denoted as stromal or mesenchymal stem cells. Bone marrow contains two main cell types: hematopoietic cells and stromal cells. The stem cells for non hematopoietic tissues are referred as mesenchymal cells because of their ability to differentiate as mesenchymal or stromal cells. Mesenchymal cells are easily obtainable from bone marrow by means of minimally invasive approach and can be expanded in culture and permitted to differentiate into the desired lineage. The differentiation can be reached by the application of bioactive signaling molecules, specific growth factors. The transforming growth factor beta (TGF-beta) superfamily member proteins such as the bone morphogenetic proteins (BMP-s) are the most important factors of chondrogenic and osteogenic differentiation of mesenchymal stem cells. From the series of recently identified factors, BMP 2,4 and 7 may play an important role in chondrogenic and osteogenic differentiation proteins. Little is known, however, about the signaling pathway involved in tenogenesis of mesenchymal stem cells, but there are some encouraging data about fibroblastic differentiation. The success of growth factor therapy needs a delivery system with biomaterials. Mesenchymal stem cells have become promising vehicles for gene therapy, cell therapy and tissue engineering. In present review, authors deal with the experimental investigations and with the clinical application of the adult bone marrow derived mesenchymal stem cells with bioactive molecules, growth factors.