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Induced pluripotent stem cells (iPSCs) have emerged as a transformative cell source for tissue\u2010engineered vascular grafts (TEVGs), offering unlimited self\u2010renewal, patient\u2010specific or universal donor potential, and the capacity to generate all vascular cell lineages. Recent breakthroughs\u2014including iPSC\u2010derived grafts achieving 100% patency in allogeneic primate models and the first United States Food and Drug Administration (FDA) approval of an acellular tissue\u2010engineered vessel (SYMVESS, December 2024)\u2014signal that clinical translation is accelerating. This review provides a comprehensive synthesis of the iPSC\u2010to\u2010graft pipeline, encompassing vascular cell differentiation protocols, biomaterial scaffold design, immune engineering strategies for universal grafts, bioreactor maturation, preclinical evaluation, and the evolving clinical\u2010regulatory landscape. We critically evaluate how the convergence of clustered regularly interspaced short palindromic repeats (CRISPR)\u2010based immune editing, advanced biomaterials, and scalable manufacturing is reshaping the field toward off\u2010the\u2010shelf vascular grafts. Finally, we identify remaining challenges in long\u2010term patency, thrombogenicity, and manufacturing scalability, and propose a translational roadmap for the next decade.<\/jats:p>","DOI":"10.1002\/jcp.70226","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T18:20:09Z","timestamp":1788459609000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Induced Pluripotent Stem Cell\u2010Derived Small\u2010Diameter Vascular Grafts: Scaffold Design, Immune Engineering, and Clinical Translation"],"prefix":"10.1002","volume":"241","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5289-0233","authenticated-orcid":false,"given":"Dohee","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering Dongguk University Seoul South 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