<p>In recent years, mesenchymal stem cells (MSCs) have garnered significant attention as promising therapeutic tools for various diseases. To date, over ten MSC-based therapies have been approved and marketed worldwide, with their potential applications increasingly recognized. In gynecology, the exploration and clinical application of MSCs has advanced rapidly, with MSCs derived from diverse sources—including bone marrow, adipose tissue, menstrual blood, umbilical cord, umbilical cord blood, and placenta—undergoing extensive research and clinical trials. Due to their self-renewal, multidirectional differentiation, and immunomodulatory capabilities, MSCs offer promising prospects for treating gynecological diseases. MSCs are being explored for the treatment of various conditions, such as uterine adhesions, endometriosis, premature ovarian insufficiency, polycystic ovary syndrome, pelvic floor dysfunction, and gynecological tumors. Notably, MSC therapies for uterine adhesions and early-onset ovarian failure have progressed to clinical application, demonstrating notable efficacy. However, challenges remain in applying MSCs in gynecology, including cell source selection, standardization of preparation methods, and assessment of safety and efficacy. This review aims to systematically summarize the current status of MSC applications in gynecology, analyze existing challenges, and propose future directions for development. With advancements in technology and ongoing research, MSCs are expected to demonstrate broader applications in gynecological disease treatment, benefiting a larger number of patients.</p>