The article reviews the clinical applications of stem cell-derived exosomes, highlighting their advantages over traditional stem cell therapy, such as non-immunogenicity, non-infusion toxicity, and ease of preservation. Exosomes can inherit therapeutic effects from their parental cells, including embryonic and adult stem cells, and have shown promise in treating various surgical conditions across multiple specialties. The review covers the biogenesis, composition, and uptake of exosomes, as well as their production, isolation, and modification techniques. It also discusses the therapeutic effects of exosomes in orthopedic and trauma surgery, neurosurgery, and other fields, emphasizing their potential in fracture healing, osteoarthritis, spinal cord injury, muscle and tendon tears, and neurodegenerative diseases like Alzheimer's. The article concludes by recommending future research that integrates insights from surgeons, nanomedicine practitioners, and stem cell researchers to further advance the use of stem cell-derived exosomes in clinical settings.The article reviews the clinical applications of stem cell-derived exosomes, highlighting their advantages over traditional stem cell therapy, such as non-immunogenicity, non-infusion toxicity, and ease of preservation. Exosomes can inherit therapeutic effects from their parental cells, including embryonic and adult stem cells, and have shown promise in treating various surgical conditions across multiple specialties. The review covers the biogenesis, composition, and uptake of exosomes, as well as their production, isolation, and modification techniques. It also discusses the therapeutic effects of exosomes in orthopedic and trauma surgery, neurosurgery, and other fields, emphasizing their potential in fracture healing, osteoarthritis, spinal cord injury, muscle and tendon tears, and neurodegenerative diseases like Alzheimer's. The article concludes by recommending future research that integrates insights from surgeons, nanomedicine practitioners, and stem cell researchers to further advance the use of stem cell-derived exosomes in clinical settings.