Tendon diseases commonly lead to physical disability, exerting a profound impact on the routine of affected patients. These conditions respond poorly to existing treatments, presenting a substantial challenge for orthopedic scientists. Research into clinical translational therapy has yet to yield highly versatile interventions capable of effectively addressing tendon diseases, including tendinopathy. Stem cell‐based therapies have emerged as a promising avenue for modifying the biological milieu through the secretion of regenerative and immunomodulatory factors. In the current review, we provide an overview of the intricate tendon microenvironment, encompassing various tendon stem progenitor cells within distinct tendon sublocations, gene regulation and pathways pertinent to tendon development, and the pathology of tendon diseases. Subsequently, we discuss the advantages of stem cell‐based therapies that utilize distinct types of autologous and allogeneic stem cells for tendon regeneration at the translational level. Moreover, this review outlines the challenges, gaps, and future innovations to propose a consolidated stem cell‐based therapy to treat tendinopathy. Finally, we discuss regenerative soluble therapies, insoluble bio‐active therapies, along with insoluble bio‐active therapies, and implantable three‐dimensional scaffolds for tendon tissue engineering, thereby presenting a pathway toward enhanced tissue regeneration and engineering.This article is protected by copyright. All rights reserved