Human tissue that has been removed from patients during surgeries or blood draws and is no longer needed for further diagnostics or therapy serves as the basis for medical research. In particular, conducting genetic tests on such surplus tissue presents various legal questions for treating physicians, pathologists, tissue banks, ethics committees, researchers, and affected patients. These questions pertain to ownership, consent, anonymization, data protection, fundamental rights to personality protection, and the right to informational self-determination. The work provides a comprehensive overview of the currently applicable legal and ethical regulations in Germany, England, and the USA, including international guidelines for the use and storage of surplus tissue. It develops potential solutions for how tissue banks can operate under the current regulations.