Composite sleeve repairs have been used in the pipeline industry for the last 25+ years. Fiberglass sleeves (e.g., Clock Spring®) were initially introduced in the market and are still being used as a proven pipeline repair method. For the last 15+ years, new composite materials have been introduced in the industry to provide a wider variety of repair options depending on the type of imperfections being repaired. Regulations in the U.S.A. and Canada share some requirements regarding design, installation, testing, and assessment of composite sleeve repairs. The U.S. Department of Transportation (DOT) through the Pipeline and Hazardous Materials Safety Administration (PHMSA) recommends the use of repair methods consistent with industry standards. The 2019 version of the Canadian CSA Z662 Oil and Gas Pipeline Standard includes requirements for testing and qualification according to the American Society of Mechanical Engineers (ASME) regulation PCC-2 or ISO/TS 24817, and requirements for conducting an engineering assessment to determine the subsequent maximum stress on the pipe sleeve. This paper compares the regulatory requirements for pipeline composite sleeve repairs in the U.S.A. and Canada; it describes some of the options for composite sleeve repair, and reviews engineering assessments of methodologies for composite sleeve repair.