Semiconductor saturable absorber mirror (SESAM) mode-locked thin disk lasers define the state-of-the-art performance for high average power and high pulse energy femtosecond laser oscillators. To date pulse energies above 30 µJ and average powers above 140 W have been demonstrated. In this paper we review the achievements of mode-locked thin disk lasers in terms of average power and pulse energy. Stable mode locking requires single transverse mode operation even at the highest average power, which is challenging and therefore addressed in more detail. We then summarize our expectations on the main challenges and limitiations for the next generation of mode-locked thin disk laser oscillators with an average power above 500 W and pulse energies in excess of 100 µJ.