The repair and regeneration of large bone defects resulting from disease or trauma remains a significant clinical challenge. There has been increasing interest in using bioactive glass as a scaffold material for bone tissue engineering due to its appealing characteristics. However, the application of glass scaffolds for the repair of load-bearing bone defects is often limited by their low mechanical strength and fracture toughness. This chapter focuses on recent advances in the development and use of bioactive glass scaffolds for bone tissue engineering applications. Scaffolds with compressive strengths comparable to those of trabecular and cortical bones have been achieved using a variety of processing methods. The low fracture toughness (low resistance to fracture) and limited mechanical reliability remain key limitations for bioactive glass scaffolds. Multiple approaches to manipulate the structure and performance of bioactive glass are discussed. Future research directions including the development of strong and tough bioactive glass scaffolds and their evaluation in unloaded and load-bearing bone defects in animal models are recommended.