Acute kidney injury (AKI) is a renal disease that is associated with high mortality. Current treatments mostly rely on supportive therapies and do not directly target the disease. Regenerative medicine, however, offers potentially direct AKI therapy through two strategies: cell transplantation and kidney reconstruction. Regarding cell transplantation, several cell types are potential sources, including hematopoietic stem cells, mesenchymal stem cells, and renal stem/progenitor cells within the adult kidney tissue or derived from human-induced pluripotent stem cells (iPSCs). On the other hand, kidney reconstruction could provide a curative treatment for severe AKI and consequent chronic kidney disease (CKD). Many methods have been proposed for the kidney reconstruction, including self-organization, blastocyst complementation, decellularization, and bioartificial kidneys. However, there are still a number of obstacles to overcome before reconstructed kidneys reach clinical use. In this review, we summarize the recent progresses in cell transplantation and kidney reconstruction as strategies to treating AKI.