Organoids have emerged as powerful tools for disease modeling, mechanistic exploration, drug screening, and regenerative medicine. Spinal cord and peripheral nerve organoids mimic real organs in terms of cell morphology, tissue structure, and function, offering new possibilities for tissue engineering therapies in spinal cord injury (SCI) and peripheral nerve injury (PNI). In this review, we introduce the genesis and structure of the spinal cord and peripheral nervous system and summarize the key factors for constructing spinal cord and peripheral nerve organoids. We then discuss the recent advances in the formation of three-dimensional (3D) organoid structures through engineering approaches and explore their potential applications in neural tissue engineering. Finally, we address current challenges such as the high heterogeneity among neural organoids and incomplete replication of organ functions. Future development of engineered matrix materials and manufacturing methods is crucial for further clinical translation of organoids in spinal cord and peripheral nerve repair.