Abstract Traumatic injury to a peripheral nerve not only provokes a localised response at the wound site but also triggers changes centrally within the spinal cord and brain and peripherally at the target organ. It is therefore perhaps not surprising that functional outcome after the (focal) clinical repair of such injuries, even in best-case scenarios, is frequently disappointing. When clinical intervention is required, e.g. when the two stumps of a divided nerve cannot be sutured together without placing them under unacceptable tension, the ‘gold standard’ repair is a peripheral nerve autograft to bridge the gap between the nerve stumps. The microenvironment provided by an autograft is ‘primed’ to facilitate axonal regrowth, because it contains a population of axon-responsive Schwann cells lying in appropriately oriented laminin-rich basal lamina tubes. However, experience has shown that autografts are not ideal, for reasons which include fascicular and modality mismatch and donor site morbidity. Tissue-engineered conduits which mimic the microenvironment of an acutely transected peripheral nerve may provide an alternative to autografts. These bioprostheses must be able to direct and sustain axonal outgrowth, as well as providing haptotactic and chemotactic guidance cues for the regrowing axons and their associated cells as they grow towards the distal nerve stump. In addition, they must be fashioned from materials which are biocompatible and bioresorbable and which possess an appropriate compressive modulus. This chapter reviews the experimental data informing the design of tissue-engineered alternatives to nerve autografts.