Extracellular vesicles (EVs), particularly exosomes, have emerged as promising tools in nanomedicine and regenerative medicine. Exosomes are small nanovesicles secreted by various cells, containing proteins, lipids, and nucleic acids, and capable of modulating cellular functions. They offer advantages such as biocompatibility, stability, and the ability to deliver various cargoes, making them ideal for biomedical applications. However, challenges remain in their clinical application, including the need for efficient isolation techniques, limited circulation time, and suboptimal targeting. Recent advancements in exosome-based strategies have expanded their use in cancer therapy, immunotherapy, and biomarker research. Exosomes derived from mesenchymal stem cells (MSCs) show potential in regenerative medicine due to their ability to promote tissue repair. Despite these advancements, challenges such as high costs and technical limitations in large-scale production persist. Exosome-based drug delivery systems have shown promise in treating various diseases, including brain, lung, liver, and other disorders. Exosomes can be engineered to target specific tissues and deliver therapeutic agents, enhancing their potential in personalized medicine. Exosome-based immunotherapy has also gained attention for its ability to modulate immune responses and enhance antitumor immunity. Overall, exosomes represent a significant advancement in nanomedicine and regenerative medicine, with ongoing research aimed at overcoming current limitations and expanding their clinical applications.Extracellular vesicles (EVs), particularly exosomes, have emerged as promising tools in nanomedicine and regenerative medicine. Exosomes are small nanovesicles secreted by various cells, containing proteins, lipids, and nucleic acids, and capable of modulating cellular functions. They offer advantages such as biocompatibility, stability, and the ability to deliver various cargoes, making them ideal for biomedical applications. However, challenges remain in their clinical application, including the need for efficient isolation techniques, limited circulation time, and suboptimal targeting. Recent advancements in exosome-based strategies have expanded their use in cancer therapy, immunotherapy, and biomarker research. Exosomes derived from mesenchymal stem cells (MSCs) show potential in regenerative medicine due to their ability to promote tissue repair. Despite these advancements, challenges such as high costs and technical limitations in large-scale production persist. Exosome-based drug delivery systems have shown promise in treating various diseases, including brain, lung, liver, and other disorders. Exosomes can be engineered to target specific tissues and deliver therapeutic agents, enhancing their potential in personalized medicine. Exosome-based immunotherapy has also gained attention for its ability to modulate immune responses and enhance antitumor immunity. Overall, exosomes represent a significant advancement in nanomedicine and regenerative medicine, with ongoing research aimed at overcoming current limitations and expanding their clinical applications.