Engineered nanoparticles, in particular metal oxide nanoparticles, with their unique and novel properties, enable a plethora of new applications in various fields of research. These new properties have raised concerns about potential adverse effects for the environment and human health and are nowadays very controversial. A reliable, cost- and time-effective, rapid and mechanistic-based testing strategy is needed to replace current conventional phenomenological assessments. Today’s in vitro technology, providing human-based advanced cellular models representing different organ barriers such as skin, lung, placenta, or liver, may cover this need. The aim of this article is to present the current changes in (nano) toxicology strategies, the extent to which in vitro models have achieved general acceptance, and how the relevance of these models can further be improved using examples of selected metal oxide nanoparticles.