Multipotent mesenchymal stromal cells’ (MSCs) are the most common type of stem cell used in the regeneration of skeletal tissue. These cells have multipotent, angiogenic, paracrine, anti-fibrotic and immunological properties. They are readily available, easily isolated and have many therapeutic applications. The ageing population is on the increase and with this comes an upsurge in medical conditions that may benefit from novel stem cell-based therapies to treat ageing-associated diseases. Given that autologous implantations have shown to be beneficial in these targeted therapies, questions are raised regarding the effect of ageing on the efficacy of stem cells. In this review article we summarise the effect of ageing on MSCs with a brief discussion on future therapeutic strategies that may be used to overcome these effects.