Tendon and ligament injuries are a global health problem, afflicting millions of people annually. As almost all skeletal muscles require tendons for bone attachment and ligaments for proper joint function, loss of their integrity causes significant functional impairment. Tendons and ligaments have low self-regenerative capacities due to their hypocellular and hypovascular nature, leading to complex and prolonged natural rehabilitation. Thanks to developments in the fields of bioengineering, biomaterials, and cell biology, tissue engineering represents a promising approach to enhance the repair and regeneration of tendons and ligaments or to replace them. A better understanding of the mechanisms governing tendon and ligament healing is critical in developing an effective therapy. So far extensive clinical studies are missing in this area. Moreover, there remains a shortage of preclinical studies pertaining to ligament repair. This chapter examines tissue-engineered strategies for tendon and ligament repair and reconstruction detailing the fundamental elements and state-of-the-art technology.