Each year, millions of people worldwide die from traumatic tissue injuries or pathological tissue defects, posing significant challenges for the repair of tissue damage [1,2]. Traditional surgical transplantation struggles to meet clinical needs due to critical issues such as donor shortages and immunological rejection [3]. Tissue engineering focuses on the structural and functional repair and regeneration of tissues and organs damaged by disease, trauma, and other causes [4,5]. It offers a promising alternative to conventional treatments and represents a key direction in regenerative medicine. Natural tissue microenvironments feature complex three-dimensional ECM networks and coordinated cellular ecosystems. It poses considerable challenges for tissue engineering materials to accurately replicate these characteristics. Therefore, developing biomaterials that can mimic the structural and physicochemical properties of natural tissues is crucial to overcoming bottlenecks in tissue regeneration and advancing regenerative medicine [6].

Hydrogels are attractive for tissue engineering due to their ECM-like structure, high water absorption and retention capacities, and biocompatibility [[7], [8], [9], [10], [11]]. Unlike traditional hydrogels, fiber composite hydrogels provide directional guidance, tunable mechanical reinforcement, and efficient delivery of active ingredients [[12], [13], [14]], yet no comprehensive review has focused on how fabrication strategies link to regenerative outcomes [15,16]. A comprehensive summary and analysis of related research clarify the current research landscape, while guiding future directions in this dynamic field.

This review systematically summarizes recent advances in fiber composite hydrogels for tissue regeneration applications (Fig. 1). We begin by summarizing typical fabrication strategies: blending, lamination, 3D printing, and in situ phase separation methods. Subsequently, the inherent advantages of fibrous composite hydrogels in regenerative medicine are detailed. Then, we highlight cutting-edge developments in tissue-specific applications, including nerve, bone, vascular, and skin tissue regeneration. Finally, the main challenges faced by fiber composite hydrogel materials and their future development directions in tissue engineering applications are proposed.