• Adoptive Cell Therapy (ACT) has become an emerging pillar of medicine. • ACT may treat autoimmunity, cancer, infectious diseases, and non-immune diseases. • Synthetic biology has transformed our ability to enhance and control cell therapies. • Non-viral targeted cell engineering with CRISPR is a flexible means to rewire cells. • Universal cells are on the horizon and could bring cell therapy to the masses. T lymphocyte and other cell therapies have the potential to transform how we treat cancers and other diseases that have few therapeutic options. Here, we review the current progress in engineered T cell therapies and look to the future of what will establish cell therapy as the next pillar of medicine. The tools of synthetic biology along with fundamental knowledge in cell biology and immunology have enabled the development of approaches to engineer cells with enhanced capacity to recognize and treat disease safely and effectively. This along with new modes of engineering cells with CRISPR and strategies to make universal 'off-the-shelf' cell therapies will provide more rapid, flexible, and cheaper translation to the clinic. [ABSTRACT FROM AUTHOR]