In this article we report the use of sprayed, cultured autologous keratinocytes in combination with widely meshed autografts (both Meek and lattice techniques) and report here three cases with significant full thickness burns. The patients had 8% (elderly), 31% (non-healing) and 90% TBSA burns. We also report 2 patients treated with cultured cells alone; a 56% TBSA (non-healing) and a 15% TBSA female ballerina who wished to avoid unnecessary donorsite scars. While the observational data we have reported here gives us hope for the future use and development of sprayed cultured autologous keratinocyte therapy, it is by no means conclusive. There have been several calls within the burns community for a higher level of research to be conducted to evaluate the efficacy of cultured epithelial cells in the treatment of burns [19,29,45]. A detailed retrospective audit of 84 patients over an 11-year period at one Centre demonstrates the great potential of this treatment . A blind, prospective study of areas treated with a combination of meshed autograft plus cultured cells compared with matched areas treated with meshed autograft alone is underway at our Centre. It is hoped that the results of such a study will be able to answer the questions posed by the burns community as to the true efficacy of cultured cell therapy.