Infertility has become a worldwide issue, and many patients cannot benefit from assisted reproductive technologies (ART). The extracellular matrix (ECM) is critical in tissue organization and remodeling. The female reproductive system plays an important role in menstruation, pregnancy, and ovulation and may influence fertility. In addition, ECM has a wide variety of components, good biological properties, and extensive application experience as a biomaterial. In-depth research on the ECM in the female reproductive system and the development and application of ECM-derived materials may provide new ideas for solving infertility problems. This review aimed to summarize the regulation and changes of ECM in the uterus and ovary, and to discuss the progress of research on ECM-derived materials in reproductive tissue engineering. An extensive search in PubMed and Embase was conducted using keywords including extracellular matrix, uterus, ovary, tissue engineering, and material. We are devoted to combining research on ECM-derived materials with clinical practice and intend to provide ideas for solving clinical problems in reproductive medicine.