More than 20 years after the introduction of stem cells as a potential tool for cardiovascular regenerative medicine (CRM), the possibility of modulating cardiac regeneration in humans is still considered the most promising alternative to overcome the limitations of existent treatments for cardiovascular failure. However, CRM has not yet showed clear improvements over standard therapies in terms of clinical outcomes. Therefore, there is a compelling need and willingness among clinicians and scientists to discuss progress and hurdles of CRM in an open forum. This has been the aim of the International Symposium on Cell Therapy and Cardiovascular Innovations (TECAM, http://www.cardiovascularcelltherapy.com) since its inception 14 years ago. The latest edition of the TECAM conference was held in Madrid last May 12th and 13th. During the meeting, recent breakthroughs, open questions, and future steps were debated by the main experts worldwide and are summarized in this article.