Purpose <p>Ovarian failure and dysfunction represent significant opportunities for ovarian replacement via ovarian tissue engineering (OTE). This review explores advancements in OTE as a promising strategy to restore ovarian function, emphasizing the potential role of OTE in overall health, longevity, and fertility. By analyzing these advancements, this review underscores the importance of OTE related to ovarian dysfunction and advancing women’s health.</p> Methods <p>A narrative review of OTE was conducted. Topics investigated include: (1) the recent technological developments in fertility preservation, including the use of ovarian tissue cryopreservation; (2) advancements in scaffold-based technologies and biomaterials, including alginate and fibrin that support follicle growth and viability; and (3) the concept of an artificial ovary, encapsulating ovarian follicles and stromal cells within biomaterials to replicate ovarian functions.</p> Results <p>The preservation of ovarian tissue has become vital in reproductive medicine. Advances in OTE offer promising opportunities to recreate normal ovarian tissue and improve fertility preservation. This review examines the use of various natural and synthetic polymers in bioengineered ovaries. Emerging technologies, such as three-dimensional (3D) printing and microfluidics, are also discussed for creating complex structures and manipulating fluids at small scales to replicate systemic ovarian function.</p> Conclusion <p>This review highlights the significant engineering aspects of OTE, advocating research that prioritizes biomaterial refinement, cell sourcing, and ethical considerations in stem cell therapy. Advancements in 3D printing and microfluidics are crucial for developing bioengineered ovarian functions. Recognizing the ovary’s diverse biological functions beyond fertility will broaden the innovation of research in this field.</p> Lay Summary <p>Ovarian dysfunction poses significant fertility and health challenges. OTE offers innovative solutions to restore ovarian function. This review discusses advancements in OTE, including biomaterials and technologies that support ovarian follicle growth and viability,&#xa0;aiming to improve fertility preservation and ovarian functions.</p> Future View <p>Future research in OTE should concentrate on refining 3D culture systems with advanced polymers to enhance follicle survival. Additionally, integrating angiogenic factors will be crucial for developing vascular networks, while utilizing stem cell-derived granulosa-like cells may offer innovative strategies for restoring fertility in at-risk patients.</p>