The article reviews the potential of extracellular vesicles (EVs) and exosome-like nanovesicles (ELNVs) as oral drug delivery systems. EVs and ELNVs are natural nanocarriers with unique structural, compositional, and morphological characteristics, making them promising for therapeutic applications. The review highlights the characteristics of EVs, including their oral administration and therapeutic activity. Milk and plant EVs can exert therapeutic effects through their protein, nucleic acid, and lipid components. Methods for loading drugs into exosomes and targeting exosomes have been explored to enhance their therapeutic capability. EVs are discussed as potential drug carriers, and ELNVs are considered for disease prevention and treatment. The article also addresses the challenges associated with the development of EVs and ELNVs from sources such as milk and plants, as well as concerns with standardized applications. The review concludes by discussing the advantages and limitations of using EVs and ELNVs for oral drug delivery, emphasizing their potential in clinical translation.The article reviews the potential of extracellular vesicles (EVs) and exosome-like nanovesicles (ELNVs) as oral drug delivery systems. EVs and ELNVs are natural nanocarriers with unique structural, compositional, and morphological characteristics, making them promising for therapeutic applications. The review highlights the characteristics of EVs, including their oral administration and therapeutic activity. Milk and plant EVs can exert therapeutic effects through their protein, nucleic acid, and lipid components. Methods for loading drugs into exosomes and targeting exosomes have been explored to enhance their therapeutic capability. EVs are discussed as potential drug carriers, and ELNVs are considered for disease prevention and treatment. The article also addresses the challenges associated with the development of EVs and ELNVs from sources such as milk and plants, as well as concerns with standardized applications. The review concludes by discussing the advantages and limitations of using EVs and ELNVs for oral drug delivery, emphasizing their potential in clinical translation.