With the 2007 Nobel prize awards to Evans, Capecchi and Smithers, embryonic stem cell research has been rightly recognized for its enormous contributions towards increasing our understanding of mammalian development and disease. Much of this insight has arisen from the provision of mice knock out models. However, observations that the embryonic stem cell can be coaxed into a multitude of different cell types in vitro have also captured enormous attention. This matchless versatility is now being intensively exploited in human embryonic stem cells (hESC) with a view to providing partial or complete cures for a vast legion of troubling human ailments. Whilst the pluripotential nature of hESC offers the advantage, in principle, of allowing a wide choice of disease targets, the early developmental status of the cells makes efficient and correct differentiation into the desired adult cell types a difficult undertaking. In my lecture, I will explore the challenges and progress that accompany the translational efforts being made with hESC. In particular, I will survey progress towards clinical applications in the diabetes, congestive heart failure and spinal injury indications, paying attention to outstanding regulatory issues like safety and GMP compliance in this very difficult area of cell therapy. I will conclude that technical difficulties together with regulatory and investment concerns, are likely to impede clinical development of hESC cell therapy. However, I will also describe some recent research using conditioned media from hESCderived mesenchymal stem cells, that may provide a shorter timeline to the clinic.