Autologous fat grafting has been around for over a century. However, only recently has its regenerative potential been discovered. Adipose tissue contains adipose tissue-derived stem cells (ADSC), a mesenchymal stem cell type. These cells are likely to be responsible for the regenerative potential of adipose tissue. ADSC are able to differentiate into multiple lineages of the mesoderm and secrete a whole variety of cytokines and growth factors that are known to play a role in normal wound healing. However, the exact mechanism by which ADSC could cause tissue regeneration is not known. It is though that ADSC contribute to tissue regeneration by paracrine means, or by taking part in tissue remodeling them self. This report will give an overview of autologous fat grafting, how it started and how it has evolved over time, its clinical use and its future potential, and the underlying mechanisms that could possible explain its regenerative potential.