Few biopharmaceutical preparations developed from biologicals are available for tissue regeneration and scar management. When developing biological treatments with cellular therapy, selection of cell types and establishment of consistent cell banks are crucial steps in whole-cell bioprocessing. Various cell types have been used in treatment of wounds to reduce scar to date including autolog and allogenic skin cells, platelets, placenta and amniotic extracts. Experience with fetal cells show that they may provide an interesting cell choice due to facility of out-scaling and known properties for wound healing without scar. Differential gene profiling has helped to point to potential indicators of repair which include cell adhesion, extracellular matrix, cytokines, growth factors and development. Safety has been evidenced in Phase I & II clinical fetal cell use for burn and wound treatments with different cell delivery systems. Overall fetal cells present technical and therapeutic advantages compared to other cell types for effective cell-based therapy for wound and scar management.