In the perfect world—an ideal laboratory grown vascular graft must be composed of viable tissue elements with potentials for repair and regeneration, an acceptable range of resistance to thrombosis—infections, sensitivity to vasoactive mediators, secretory and contractile properties, mimicking natural blood vessels. Three key components of generating such custom-made vessels are biocompatible polymer of natural structural proteins for building a scaffold, healthy primary vascular cells grown in the scaffold maintaining close anatomical and functional integrity, and provision for a microenvironment for providing balanced metabolic support. In addition, maintenance of a pulsatile flow of nutrients and polarization of cellular components in the synthetic vessels are also important. Obtaining decellularized vascular grafts from cadaveric donors or xenografts, populating with recipient’s primary vascular cells, and maintaining them in bioreactors or recipients own body tissue are other potential alternative approaches. Here, we will discuss some central aspects and updated information on authentic artificial blood vessel.