Stem cells are located throughout the adult body of higher organisms, supporting a continuous renewal and repair of tissues. Unique abilities of stem cells are self-renewal and multipotential differentiation. It is, therefore, of critical importance for an organism to maintain and control quantity and quality of stem cells within a given pool. Otherwise, when something goes awry within a stem cell, it is likely to have far-reaching effects. Mesenchymal stem cells (MSC) derived from various sources such as bone marrow or fat have been expanded in culture and differentiated in vitro into several lineages such as adipocytes, osteocytes or chondrocytes. In particular, aged human MSC show a decline in differentiation potential as well as in proliferation rate. The latter most likely reflects the fact that aged MSC suffer from eroded telomeres. Besides the individual age of the cell, stem and progenitor cell functions are influenced by the cellular environment, i.e. the niche and the architecture of the tissue, they reside in. This contribution reviews current knowledge about MSC aging (in vitro or in vivo), and respective difficulties for tissue engineering and stem cell therapy.