Articular cartilage injuries pose a major clinical obstacle due to their inability to regenerate contributed by cartilages’ intrinsic properties and close association with osteoarthritis and progressive joint degeneration. Cartilage damage may be a consequence of acute trauma, repeated mechanical overload or age-related degenerative processes which often leads to chronic pain, joint dysfunction and a deterioration in the quality of life of patients. Established treatments such as; conservative management, intra-articular drug administrations and surgical cartilage repair typically provide relief. However, it's important to note that these treatments rarely lead to complete, permanent regeneration of natural hyaline cartilage. Recently, regenerative medicine has been paying significant attention to stem cell therapies. It aims to support cartilage repair while simultaneously impacting the intra-articular environment. It's safe to say that these approaches are increasingly being considered as potential therapeutic methods. Between the various cell populations, mesenchymal cells have gained particular attention due to their ability to promote chondrogenic differentiation, immunomodulatory properties, and paracrine effects. There is growing evidence suggesting that stem cells effects can be mediated not only by direct source replacement but are also contributed by the secretion of bioactive factors that influence physical processes, cartilage metabolism, and endogenous repair mechanisms. This narrative review aims to concisely summarize and critically evaluate novel evidence and scientific data on the biological repair mechanisms, clinical outcomes and safety assessment of stem cell-based therapies used to treat articular cartilage repair.