The ankle is one of the most commonly injured joints in athletic individuals, with a sprain being the most frequent mechanism of injury. With the advent of advanced medical imaging techniques, surgeons have recognized that these injuries may to lead to cartilage insult in up to 50% of patients, which potentially leads to the formation of an osteochondral lesion of the talus. Suboptimal results after the primary treatment method, bone marrow stimulation, have been frequently reported in clinical studies. Therefore, the orthopaedic research community has sought to improve on the results by applying cell-based tissue engineering in the form of adding mesenchymal stem cells (MSC) to the repair site. Although still in its nascent stages, we present the current clinical evidence regarding the use of MSCs for osteochondral lesions of the talus.