The evolution of cell-based therapies has led to confusion of the usages, legalities and safety concerns presented to the physician and patient. Like most discoveries in medicine cell therapies are cutting edge breakthroughs in regenerative medicine. However, we also have a history to repeat ourselves in medicine with heightened expectations and reductionistic focuses. The progression of cell-based therapies is no exception as we see the term “Stem Cell Treatment” is being misinterpreted and misused. The original focus of stem cell therapy was replaced by medicinal signaling cells which is a more appropriate term. However, the focus is still on the cells versus the other features including cytokines, exosomes, and many more we don’t yet know of. Research and clinical observation are strongly suggesting that the number of cells has very little to do with the regeneration. The “soup” and maximization of the terrain is more critical to support the prime environment for paracrine rather than autocrine signaling. The importance of this understanding is critical in successful outcomes.