Adoptive cell therapy using tumor‑infiltrating lymphocytes (TILs) has advanced with recent regulatory approvals, but scaling manufacturing, selection, and logistics remain the primary barriers to broader clinical adoption. FDA approvals have validated the modality’s clinical potential but exposed supply‑chain and patient‑selection challenges. The review identifies unresolved issues including centralized manufacturing capacity, product variability, and the need for predictive biomarkers to select responders. Sponsors and contract manufacturers face pressure to standardize workflows and shorten vein‑to‑vein times. Health systems and payers must weigh the clinical benefit against operational complexity; TIL programs that solve manufacturing bottlenecks could capture faster market share.