Background: The tissue engineering is the evolving science that combines cells, biomaterials and biochemical factors aimed at restoring, maintaining and substituting different types of tissue. An important role is played by the use of the stem cells in various fields of medicine, including ophthalmology, namely in cases of retinopathies and optic nerve atrophy. Conclusions: Current treatment of the optic nerve atrophy is based on the etiological causes or late complications. Considering the availability of advanced therapies, stem cell therapy offers a new approach in the treatment of the atrophy of the optic nerve. Being easy to harvest and cultivate, mesenchymal stem cells are most commonly used in regenerative medicine, they can be induced to differentiate into cartilage, tendons, adipose tissue and other cell lines. Mesenchymal stem cell harvesting has no ethical issues compared to embryonic stem cell harvesting. The major histocompatibility factor II is not expressed on the surface of mesenchymal stem cells, and this great advantage allows their use in autologous or allogenic form. Mesenchymal stem cells produce growth factors with paracrine action that are thought to activate endogenous repair mechanisms, due to these properties mesenchymal stem cells have been used in several clinical studies in optic nerve disorders where immunomodulatory and neuroprotective properties have been demonstrated. All of the properties mentioned above stand for the clinical use of mesenchymal stem cells in case of optic nerve atrophy.