Introduction: Volumetric Muscle Loss (VML) occurs when trauma, tumor resection, or congenital defects cause irreversible skeletal muscle mass loss beyond natural regeneration. Current standard treatments using autologous muscle transfer are limited by donor site morbidity and inadequate functional recovery. Discussion: Cell-based therapies have shown potential in muscle regeneration, utilizing satellite cells, mesenchymal stem cells, and immune modulators. However, challenges persist with poor cell redistribution from injection sites. Tissue engineering advances have emerged, combining biological scaffolds with progenitor cells and developing hydrogels, nanofibrous scaffolds, and electroconductive materials that mimic native muscle structure. 3D bioprinting technology has enabled precise spatial positioning of cells and biomaterials, addressing previous limitations in myocyte orientation. Clinical trials with ECM scaffold implantation have yielded encouraging results, demonstrating improvements in muscle strength and range of motion. Persistent challenges remain, including inadequate vascularization, insufficient innervation, and host compatibility issues. Conclusion: Combining traditional reconstructive techniques with regenerative medicine strategies offers promising solutions for VML injuries. This approach potentially improves functional outcomes and patient quality of life, despite existing technological limitations.