High resolution SEM, light microscopy, and non-invasive CT/MRI imaging can produce 3D views of anatomy and generate computational tissue models for many biomedical and tissue engineering applications. Recently, the integration of image processing with computer-aided design (CAD), computer aided manufacturing (CAM), and solid freeform fabrication technology has achieved a remarkable advance in the field of computer-aided tissue engineering (CATE). This paper presents an overview of CATE, including its application in computer-aided tissue modeling, computer-aided tissue informatics, and computer-aided tissue scaffold design and manufacturing. An image-based 3D reconstruction approach, along with a discussion of various enabling reverse engineering techniques for structural representation and CAD based modeling of tissue anatomy will be introduced. An example of biomimetic modeling and design of 3D heterogeneous bony tissue structures under anatomical, biological, and mechanical constraints will also be presented.