Cardiovascular disease is a major public health problem in the United States. In many survivors, extensive tissue damage from myocardial infarction leads to the development of congestive heart failure. Unfortunately, thus far, heart transplantation has remained the only viable treatment for end-stage congestive heart failure. Lack of available donor hearts has thus led to search for alternative therapies. Among these, cell therapy has raised a great enthusiasm for myocardial repair. However, it suffers limitations associated with cell retention, survival and differentiation. In addition, the results from preclinical and clinical studies based on such treatments have generated mixed results. For this reason, hybrid therapies that incorporate tissue engineering are being developed as potentially new therapeutic approaches for repair of myocardial tissue. Here, we review the current progress in cardiac tissue repair and engineering; and discuss the new emerging technologies.