Since their discovery, there has been significant progress in the understanding of dendritic cell (DC) biology. Their capacity for priming an immune response against pathogens and cancers has been exploited clinically. However, the objective responses obtained to date using DC cancer vaccines have been modest. Suboptimal DC preparations, limited tumor target antigens, and the essential need to initiate trials in immunocompromised patients with advanced disease, have all contributed to limited outcomes. The use of fully activated DCs, loaded with multiple, immunogenic, cancer-specific antigens, administered to patients with minimal residual disease and the manipulation of regulatory mechanisms underlying peripheral tolerance, may be the ingredients for future success.