Tumor-derived exosomes (TDEs) play a critical role in tumor progression by modulating the tumor microenvironment (TME). They facilitate communication between tumor cells and surrounding cells, influencing processes such as epithelial-mesenchymal transition (EMT), macrophage polarization, angiogenesis, and immune evasion. TDEs contain various molecules, including DNA, RNA, miRNAs, lipids, and proteins, which can alter the TME and promote tumor growth. They contribute to tumor progression by inducing immune escape, promoting metastasis, and reprogramming metabolic activity. TDEs also regulate cancer stem cell (CSC) maintenance and tumor cell invasion. In addition, TDEs are being explored as potential biomarkers for tumor diagnosis and as therapeutic targets for cancer treatment. Their ability to deliver therapeutic agents and modulate immune responses makes them promising candidates for future cancer therapies. However, challenges remain in accurately quantifying TDEs and improving their therapeutic efficacy. Further research is needed to fully understand the mechanisms by which TDEs influence tumor progression and to develop effective strategies for their clinical application.Tumor-derived exosomes (TDEs) play a critical role in tumor progression by modulating the tumor microenvironment (TME). They facilitate communication between tumor cells and surrounding cells, influencing processes such as epithelial-mesenchymal transition (EMT), macrophage polarization, angiogenesis, and immune evasion. TDEs contain various molecules, including DNA, RNA, miRNAs, lipids, and proteins, which can alter the TME and promote tumor growth. They contribute to tumor progression by inducing immune escape, promoting metastasis, and reprogramming metabolic activity. TDEs also regulate cancer stem cell (CSC) maintenance and tumor cell invasion. In addition, TDEs are being explored as potential biomarkers for tumor diagnosis and as therapeutic targets for cancer treatment. Their ability to deliver therapeutic agents and modulate immune responses makes them promising candidates for future cancer therapies. However, challenges remain in accurately quantifying TDEs and improving their therapeutic efficacy. Further research is needed to fully understand the mechanisms by which TDEs influence tumor progression and to develop effective strategies for their clinical application.