autologous patient specific chimeric antigen receptor t cell cart therapy has emerged as a powerful and potentially curative therapy for cancer especially for cd19 positive hematological malignancies indeed on august 30 2017 the university of pennsylvania designed cd19 directed cart cart 19 cell therapy ctl019 tisagenlecleucel t kymriah novartis became the first cart therapy approved by the food and drug administration fda for acute lymphoblastic leukemia however the development of cart technology and its wider application is partly limited by the patient specific nature of such a platform and by the time required for manufacturing the efficacious generation of universal allogeneic cart cells would overcome these limitations and represent a major advance in the field however several obstacles in the generation of universal cart cells need to be overcome namely the risk of cart rejection and the risk of graft versus host disease mediated by the allogeneic cart in this review we discuss the different strategies being employed to generate universal cart and provide our perspective on the successful development of a truly off the shelf cart product.