Three-dimensional (3D) tissue models have emerged as transformative platforms for mimicking the structural and functional complexity of biological tissues, yet they remain limited by the lack of precise spatiotemporal regulation of local microenvironments. Current organoid systems, derived from induced pluripotent stem cells (iPSCs), face challenges including hypoxia, inefficient nutrient transport, uncontrolled cellular differentiation, and high variability in spatial organization, often resulting in necrotic cores and incomplete recapitulation of tissue functions. To address these limitations, we propose the development of Bio-Hybrid Hierarchical Organoid-Synthetic Tissues (Bio-HhOST) —a new class of bio-hybrid engineered living materials (ELMs), which integrate live cells with precision-engineered artificial cells (ACs). ACs are compartmentalised, microscale constructs capable of dynamic, two-way communication with living cells through chemically mediated signalling. By sensing intercellular cues and releasing growth factors or morphogens on demand, ACs provide local, programmable regulation of tissue development and function. In Bio-HhOST constructs, ACs will be co-localised with live cells, creating chemically programmable organoid-synthetic tissues that overcome the constraints of homogeneous external regulation. This interdisciplinary approach—combining biology, material engineering, and synthetic chemistry—enables new levels of control over proliferation, differentiation, and tissue morphogenesis. Ultimately, Bio-HhOST will establish a paradigm shift in the design of 3D tissue models, advancing the vision of next-generation programmable and functional living materials for applications in drug discovery, disease modelling, and regenerative medicine.