Cells are crucial for mammalian life and perform critical functions in complex microenvironments. The heterogeneous cell surface, with variations in receptors and ligands, regulates processes such as cell adhesion, communication, immune response, and homeostasis, making it a key focus in regenerative medicine. Cell suspension therapy shows promise for intractable diseases, but heterogeneous surface markers, loss of homing signals, undesired differentiation, and poor microenvironment modulation limit its effectiveness. This chapter explores how cell surface engineering improves ligand-receptor interactions, cell homing, regulates cell fate and targeted delivery for tissue repair. Scaffold-free cellular assemblies mimic tissues, however, traditional fabrication strategies face challenges such as limited cell-cell interactions, misalignment, and difficulty in creating transplantable microtissues. This chapter explores how cell surface engineering enhances cell-cell interactions, enables precise cell patterning, and facilitates macroscale tissue fabrication. Scaffold-based tissue engineering combines cells, molecular factors, and biomaterials to create templates for tissue formation. However, traditional scaffolds face challenges such as poor cell migration, uneven distribution, and lack of bio-signals. This chapter highlights how cell surface and scaffold interface engineering modulate cell-biomaterial interactions, cellularization, and modular scaffold fabrication. Overall, this chapter emphasizes the potential of cell surface engineering in advancing tissue engineering and regenerative medicine.