Mesenchymal stromal cells (MSCs) are being explored for treatment of inflammatory, ischemic, autoimmune, and degenerative diseases. More and more of these diseases require MSCs to be delivered locally to the diseased site rather than systemically injected into patients. However, little is understood about whether cell cryopreservation or prelicensing will affect the efficacy of the locally injected product or how the local injection environment affects MSC expression of trophic factors and interactions with patient immune cells. Several groups have disagreed on whether cryopreservation hinders MSC potency and therefore it is important to understand the effects of cryopreservation on MSC function and in what contexts cryopreservation can be used. Therefore, a better understanding of MSC phenotype after local injection is needed so that cryopreservation and prelicensing can be optimized to modulate cell potency for more efficacious MSC products. Currently, it has been shown that in vivo there are rapid drastic shifts in gene expression by MSCs which have been locally injected. One of the most prominent gene changes is in the enzyme COX-2 which leads to the production of bioactive lipids called prostaglandins, namely PGE2. PGE2 has several functions depending on the context in which other cells encounter it. In order to model the gene changes that occur in vivo, in vitro cell aggregates termed spheroids have been utilized to study the effects of local injection of MSCs. MSC spheroids have shown more potency than their 2D counterparts in shifting macrophage polarization and rescue of cells from ischemic damage. This thesis examines how process variables like cryopreservation and prelicensing affect the efficacy of the MSC product in the context of local injection. Additionally, it shows how spheroid formation alters therapeutic factor expression and activity and how drug treatment and biomaterials can be utilized to modify potency of these cells. In Chapter 2, we demonstrate that cryopreservation in the context of an ischemia/reperfusion injury in the eye does not significantly decrease MSCs effectiveness in salvaging neuronal cells. However, IFN-γ, a commonly used prelicensing cytokine to increase MSC potency, led to a decrease in the effectiveness of MSCs in this model. Chapters 3 and 4 define the changes that occur to several of MSCs’ trophic factors including immunomodulatory and growth factors and how these alterations affect MSC interactions with macrophages and T cells. Because validation and tracking of locally injected products can be cost-prohibitive for many research groups, Chapter 5 lays out a low-cost method to track fluorescently labeled cells in local injections to skin to aid in minimization of variability in results obtained from animal wound healing models. These findings demonstrate that initial preparation of MSC therapeutics is critical to their efficacy in local injection. Therefore, careful testing of potency for large-scale MSC production pipelines should be evaluated to ensure the efficacy of the resulting product. Additionally, spheroids exhibit differences in the mechanisms of action due to alterations in their secretome which can be partly overcome with co-administration of steroids such as budesonide. Therefore, steroid co-administration with MSCs being considered for local application should be further explored for use in local delivery of MSCs for the treatment of inflammatory conditions. Finally, this research demonstrates the need to further understand the mechanisms by which spheroids alter their gene and trophic factor production to better tailor MSC therapies for disease specific localized injection.