Stem cell based toxicity prediction plays a very important role in the development of the drug. Unexpected
adverse effects of the drugs during clinical trials are a major reason for the termination or withdrawal
of drugs. Methods for predicting toxicity employ in vitro as well as in vivo models; however, the major drawback
seen in the data derived from these animal models is the lack of extrapolation, owing to interspecies variations.
Due to these limitations, researchers have been striving to develop more robust drug screening platforms
based on stem cells. The application of stem cells based toxicity testing has opened up robust methods to study
the impact of new chemical entities on not only specific cell types, but also organs. Pluripotent stem cells, as
well as cells derived from them, can be evaluated for modulation of cell function in response to drugs. Moreover,
the combination of state-of-the -art techniques such as tissue engineering and microfluidics to fabricate organ-
on-a-chip, has led to assays which are amenable to high throughput screening to understand the adverse and
toxic effects of chemicals and drugs. This review summarizes the important aspects of the establishment of the
embryonic stem cell test (EST), use of stem cells, pluripotent, induced pluripotent stem cells and organoids for
toxicity prediction and drug development.