The growing need for complex surgical reconstructions has led to numerous innovative strategies to develop advanced bioengineered tissues. In order for these three-dimensional structures to be clinically relevant, they must possess instant viability, sensibility, durability and biocompatibility. Building upon established models of simple cell and matrix assembly, research aims have shifted towards more complex composite structures with bespoke functionality. Understanding the complexities of the biological structures we aim to replace allows us to mimic their architecture when creating bioengineered constructs. Highlighting a number of approaches, this chapter provides an overview of the concepts and challenges in developing more complex composite tissues, and how they may be engineered to solve advanced reconstructive challenges.