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Abstract Abdominal aortic aneurysms (AAA), with approximately 200,000 new diagnoses each year, represent a prevalent clinical concern. Current treatment includes monitoring and surgical procedures once the aneurysm reaches a certain size. However, the lack of effective, timely therapies leads to a high mortality rate due to rupture. With recent advancements and innovations in biomedical science, stem cell therapy has moved closer to widespread clinical use, with the field experiencing rapid growth since its inception in the late 20^thcentury. Given the pathophysiology of AAA, stem cell therapies have high potential impact in the treatment for both early and late-stage disease, targeting underlying mechanisms such as inflammation, vascular degeneration, and extracellular matrix degradation. There are many considerations and innovative potential approaches being explored in this type of treatment, such as strategically leveraging cell properties and their associated secretome and incorporating biomaterials-based strategies. This review article summarizes and critically assesses the efficacy of cell-based therapies in AAA preclinical models, current clinical trials in this area, and other emerging bioengineering approaches for the treatment of AAA.