Glioblastoma is a highly heterogeneous and aggressive brain tumor, challenging both diagnosis and treatment. Conventional diagnostic tools and standard treatments have limited success in managing patients. Extracellular vesicles (EVs) are emerging as a promising liquid biopsy tool, offering a way to accurately identify disease severity and progression. EVs play a dual role in glioblastoma: they contribute to the creation of a heterogeneous microenvironment that promotes tumor progression and serve as biomarkers for disease diagnosis and monitoring. The review discusses the heterogeneity of glioblastoma, the role of EVs in this heterogeneity, and their potential as biomarkers. EVs can be isolated from biological fluids and used to profile disease status, providing a non-invasive method for diagnosis and treatment response monitoring. The authors propose short-term and long-term strategies based on EV biomarkers to improve glioblastoma management.Glioblastoma is a highly heterogeneous and aggressive brain tumor, challenging both diagnosis and treatment. Conventional diagnostic tools and standard treatments have limited success in managing patients. Extracellular vesicles (EVs) are emerging as a promising liquid biopsy tool, offering a way to accurately identify disease severity and progression. EVs play a dual role in glioblastoma: they contribute to the creation of a heterogeneous microenvironment that promotes tumor progression and serve as biomarkers for disease diagnosis and monitoring. The review discusses the heterogeneity of glioblastoma, the role of EVs in this heterogeneity, and their potential as biomarkers. EVs can be isolated from biological fluids and used to profile disease status, providing a non-invasive method for diagnosis and treatment response monitoring. The authors propose short-term and long-term strategies based on EV biomarkers to improve glioblastoma management.