The remarkable progresses in stem cell research and cell biological technology over the past decade have assured an exciting future for myocardial regeneration in the treatment of heart failure. In theory, we can regenerate damaged myocardium using in vivo, ex vivo, and in vitro approaches. The in vivo approach accelerates endogenous regeneration, which can be achieved by regulating cardiomyocytes to enter the cell cycle, activating cardiac stem cells, or mobilizing bone marrow stem cells, to repair the injured heart. The ex vivo approach delivers ex vivo treated autologous cells for myocardial regeneration, and includes the implantation of ex vivo expanded autologous skeletal myoblasts, bone marrow stem cells, cardiomyocytes, fibroblasts, or other tissue stem cells. Finally, the in vitro approach can also help to repair the damaged heart by implanting fetal cardiomyocytes or embryo stem cell-derived cardiomyocytes. We give an overview of the experimental studies and clinical applications of myocardial regeneration, and discuss the feasibility and problems associated with the various approaches and plans for myocardial regeneration in the treatment of heart failure.