Congenital or acquired disorders of the urethra or ureter often require adequate tissue transfer for reconstruction. A variety of biomaterials have proved to be useful in the reconstruction of the urethra or ureter in animal models and meanwhile even clinically. Innovative tissues such as acellular matrices can be placed in the host and function as a scaffold to allow the natural process of tissue regeneration. Biodegradable scaffolds can also be used as cell transplantation vehicles for the reconstruction of urethral or ureteral tissue. One of the limitations of cell-based tissue engineering techniques however is the difficulty of growing genitourinary-associated cells in large quantities in primary cultures. It can be speculated that stem cell research might help to overcome this specific problem in the future.