There is need to address the challenges of organ shortage, through development of tissues and organs with alternatives to those of the allograft-kind. This illustrates the quest behind novel biofabrication strategies such as 3D bio-printing, which is necessary to create artificial multi-cellular tissues/organs. Several findings have been reported in this review. First, the role of ECM components in tissue regenerative medicine is presented. Different ECM components such as collagen, gelatin, elastin, fibronectin, laminins and glycosaminoglycans are concisely examined for their tissue regenerative medicine applications. Next, current state of research on extrusion-based 3D bio-printing techniques and their limitations are reviewed. For example, we show that cell viability is still a challenge with extrusion, while the use of natural polymers such as collagen in improving composites’ mechanical properties is limited. Lastly, we examine unresolved research questions necessary to advance the present state of research in the field.