Fibroblasts are mesenchymal cells that can be readily cultured in the laboratory and play a significant role in epithelial-mesenchymal interactions, secreting various growth factors and cytokines that have a direct effect on epidermal proliferation, differentiation and formation of extracellular matrix. They have been incorporated into various tissue-engineered products such as Dermagraft (Advanced BioHealing, La Jolla, CA, U.S.A.) and Apligraf (Novartis, Basel, Switzerland) and used for a variety of clinical applications, including the treatment of burns, chronic venous ulcers and several other clinical applications in dermatology and plastic surgery. In this article we review the cell biology of dermal fibroblasts and discuss past and current experience of the clinical use of cultured fibroblasts.