Extracellular vesicles (EVs) are membrane-bound carriers that transport proteins, lipids, and nucleic acids between cells. Initially thought to be a means of discarding nonfunctional cellular components, EVs are now recognized as key players in intercellular and even interorganismal communication. EVs can confer stability to their cargoes and direct them to specific cell types, acting in a combinatorial manner to communicate directives. This review focuses on recent findings and knowledge gaps in EV biogenesis, release, and uptake, highlighting their roles in controlling basic cellular functions such as motility, polarization, immune responses, and development, as well as their contributions to diseases like cancer and neurodegeneration. EVs are unique in their ability to be released as stable entities and distribute over short and long distances, making them promising therapeutic delivery vehicles and biomarkers. The review also discusses the complex biogenesis mechanisms of EVs, their interactions with cells, and their roles in various physiological and pathological processes, including cell migration, immune responses, development, fertilization, mating behavior, and neurodegenerative diseases.Extracellular vesicles (EVs) are membrane-bound carriers that transport proteins, lipids, and nucleic acids between cells. Initially thought to be a means of discarding nonfunctional cellular components, EVs are now recognized as key players in intercellular and even interorganismal communication. EVs can confer stability to their cargoes and direct them to specific cell types, acting in a combinatorial manner to communicate directives. This review focuses on recent findings and knowledge gaps in EV biogenesis, release, and uptake, highlighting their roles in controlling basic cellular functions such as motility, polarization, immune responses, and development, as well as their contributions to diseases like cancer and neurodegeneration. EVs are unique in their ability to be released as stable entities and distribute over short and long distances, making them promising therapeutic delivery vehicles and biomarkers. The review also discusses the complex biogenesis mechanisms of EVs, their interactions with cells, and their roles in various physiological and pathological processes, including cell migration, immune responses, development, fertilization, mating behavior, and neurodegenerative diseases.