Poly(ε-caprolactone) (PCL) is a widely used biodegradable polymer in tissue engineering due to its excellent biocompatibility, processability, and mechanical tunability. However, its clinical translation is limited by inherent drawbacks such as hydrophobicity, low bioactivity, and slow degradation. This review aims to provide a comprehensive and critical evaluation of PCL-based scaffolds, focusing on fabrication strategies, composite modifications, and their performance across diverse tissue engineering applications. Four primary fabrication techniques-electrospinning, 3D printing, freeze-drying, and phase separation-are systematically compared in terms of structural characteristics, mechanical performance, scalability, and biological functionality. Various material modifications involving natural polymers (e.g., gelatin, chitosan, collagen), synthetic polymers (e.g., Polylactic acid, Poly(lactic-co-glycolic acid), Polyethylene glycol) and inorganic or conductive additives (e.g., hydroxyapatite, metal oxides, carbon nanomaterials) are discussed for their roles in enhancing scaffold bioactivity, degradation rate, and tissue-specific functionality. Application-specific insights are provided for PCL-based scaffolds in regenerating bone, skin, nerve, ligament, cartilage, dental and periodontal tissues, as well as emerging roles in cardiac, pulmonary, and hepatic repair. The review also highlights recent advances in intelligent scaffold design using computational modelling and artificial intelligence, and assesses sustainability, sterilisation, and regulatory challenges for clinical translation. Despite current limitations, PCL-based scaffolds show great promise for personalised and functional tissue regeneration. Future research should focus on integrating multiscale fabrication, responsive materials, green manufacturing processes, and standardised evaluation protocols. Interdisciplinary collaboration will be essential to overcome translational barriers and realise the clinical potential of PCL-based biomaterials in regenerative medicine.