Adolescent idiopathic scoliosis (AIS) is a complex spinal deformity that occurs in adolescents aged 10-18 years. It is more common in female adolescents. Despite extensive research, the precise pathological mechanisms underlying AIS are yet to be fully elucidated. Given its links to abnormal bone growth and reduced bone mineral density, the involvement of mesenchymal stem cells (MSCs) in bone metabolic disorders is considered a plausible contributing factor of AIS. This review summarizes the role of MSCs in the pathogenesis of AIS and provides a forward-looking perspective on the potential clinical application.