• This review highlights the gradient variations in the structural composition of musculoskeletal tissues and comprehensively examines recent progress in the fabrication and application of biomimetic gradient scaffolds for musculoskeletal repair.
• The challenges and prospects of gradient scaffolds for clinical application are discussed.
• Gradient scaffolds mimic the extracellular matrix of native tissues, offering improved therapeutic outcomes for bone and interface tissue regeneration.
• Advanced manufacturing techniques enable precise compositional and structural gradients, addressing the limitations of conventional bone grafts.