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Cardiovascular disease is widespread in the developed world, and many suffer from damaged heart tissue resulting in heart failure. Tissue engineering is a field combining the interests of clinicians, molecular scientists, and materials engineers. With the rapid advancement of “materials” science and an understanding of how it interacts with living cells, creating artificial tissues for organ repair seems more of a reality today than ever before. Recent reports on creating spontaneously contracting artificial heart tissue has created excitement, and has spurred on research in this area. This chapter offers a current perspective on strategies employed in engineering artificial heart tissues for reparative therapy of the damaged heart.