Tissue engineering is an interdisciplinary field that aims toward the repair of the tissues and organs by bringing together the chemists, material scientists, and biologists to work in coordination for a better understanding of cell−polymer interactions. The leading challenge in the field of tissue engineering is to mimic the naturally occurring extracellular matrix due to which scaffold engineering has become the central area of research in this field. Various materials have been investigated for the fabrication of scaffolds; silk-based composites are among the most promising materials because of their secure processing, adequate mechanical strength, biodegradability, biocompatibility, hemocompatibility, and oxygen and water permeability. This review extensively focuses on the silk-based composite scaffolds, their fabrication, sterilization, and applications in tissue engineering.