Adult mesenchymal stromal cells are plastic-adherent cells that are self-renewing and have the capacity to differentiate into various tissue specific lineages. Stromal cells were initially discovered over 100 years ago and substantial insight into stromal cell identification, isolation, characterization, and differentiation has been made, including efforts to elucidate the factors involved in stromal cell differentiation. Stromal cells have immune privilege and thus are attractive candidates for tissue engineering and regenerative medicine applications. Positive results from a number of recent investigations support the use of adult mesenchymal stromal cells for clinical application. This review article provides a brief overview of past, present, and future stromal cell technology.