Tissue engineering creates biological tissues that aim to improve the function of diseased or damaged tissues. In this chapter, we examine the promise and shortcomings of “top-down” and “bottom-up” approaches for creating engineered biological tissues. In top-down approaches, the cells are expected to populate the scaffold and create the appropriate extracellular matrix and microarchitecture often with the aid of a bioreactor that furnish the set of stimuli required for an optimal cellular viability. Specifically, we survey the role of cell material interaction on oxygen metabolism in three-dimensional (3D) in vitro cultures as well as the time and space evolution of the transport and biophysical properties during the development of de novo synthesized tissue-engineered constructs. We show how to monitor and control the evolution of these parameters that is of crucial importance to process biohybrid constructs in vitro as well as to elaborate reliable mathematical model to forecast tissue growth under specific culture conditions. Furthermore, novel strategies such as bottom-up approaches to build tissue constructs in vitro are examined. In this fashion, tissue building blocks with specific microarchitectural features are used as modular units to engineer biological tissues from the bottom up. In particular, the attention will be focused on the use of cell seeded microbeads as functional building blocks to realize 3D complex tissue. Finally, a challenge will be the potential integration of bottom-up techniques with more traditional top-down approaches to create more complex tissues than are currently achievable using either technique alone by optimizing the advantages of each technique.