The ability to create de novo tissue to replace that removed from patients during surgery is a relatively recent advance. However, this is a fast-moving field and one which surgeons must be aware of from practical, ethical and scientific viewpoints. This article gives an overview of the basic mechanisms of wound healing and regeneration and briefly touches on stem cell biology. Surgeons require a grounding in this to understand and decide upon regenerative medicine as therapy. Although focused primarily on oral pathology, the principles and references (particularly of matrices and pre-clinical models) will be of relevance and interest to all surgeons.