Objective To review the progress of cell sheet technology and its application in bone and cartilage engineering. Methods The recent literature concerning the cell sheet technology used in treatment of bone and cartilage defects was extensively reviewed and summarized. Results Cell sheet built through many different ways can protect extracellular matrix from proteolytic enzymes. As a three-dimensional structure, cell sheet can repair bone and cartilige defects via folding, wrapping scaffold, or be created by the layering of individual cell sheets. Conclusion The cell sheet technology would have a very broad prospects in bone and cartilage tissue engineering in future.