This article reviews the state of cell therapy treatments for chronic stroke. To date human studies of cell therapies for chronic stroke have demonstrated adequate safety, and efficacy suggestive of a beneficial effect in a group of patients with plateaued endogenous recovery. The potential mechanisms of action of various cell types, their routes of administration and evidence for safety and efficacy are discussed in detail. Despite promising advance in stem cell therapy for chronic stroke, there are significant challenges for developing new treatments. Investigations using animal models may yield productive avenues to further the goal of providing effective treatments for chronic stroke patients.