Human embryonic stem (hES) cells have the ability to self-renew while maintaining their pluripotency. The ability of stem cells to self-renew expansively is essential in both development and maintenance of adult tissues. ES cell lines were first generated from mouse blastocysts, these lines provided much needed information regarding ES cell propagation, growth factor dependence, and marker expression. However, the application potential of murine models is restricted in value because many differences between mouse and human ES cells have since been identified. The process of hES cells self-renewal appears to be regulated by many different pathways; however, the molecular mechanisms enabling this process are not fully characterized. Further defining these mechanisms will enable growth of hES cells under defined conditions and aid controlled differentiation of cells into specified lineages, in turn providing cells suitable for therapeutic applications. This review provides a summary of the mechanisms known to control self-renewal and pluripotency in hES cells.