<p>Ovarian aging is accompanied by a decline in the quantity and quality of follicles, leading to reduced fertility. Ovarian aging encompasses natural aging due to DNA damage, telomere attrition, and mitochondrial dysfunction, as well as a pathological functional failure caused by environmental toxins, known as a premature ovarian failure. Cell therapy is currently a focal point of research, with mesenchymal stem cells (MSCs) being particularly notable due to their wide availability, ease of expansion, strong self-renewal capabilities, multipotent differentiation, and paracrine functions. MSCs have shown great potential in the field of cell therapy, including delaying ovarian aging. MSCs can delay ovarian aging through various mechanisms: antioxidation, differentiation and regeneration, promotion of cell proliferation, inhibition of cell apoptosis, and anti-inflammatory responses. Currently, MSCs transplantation has achieved significant results in animal models, improving ovarian function and enhancing fertility. However, clinical applications still face numerous challenges, such as determining the optimal cell source, transplantation route, dosage, and long-term safety, which require further research. In this review, we will elaborate on the mechanisms of ovarian aging, the modes of action of MSCs, and the mechanisms by which MSCs delay ovarian aging, aiming to provide a theoretical basis for the clinical application of MSCs and to bring breakthroughs in the treatment of diseases such as premature ovarian failure.</p> Graphical Abstract <p></p>