Exosomes, naturally occurring nanocarriers, offer unique advantages for drug delivery due to their ability to interact with target cells and deliver therapeutic agents. They can be modified to express targeting moieties or carry specific biological activities. Exosome-based drug delivery systems are being developed for various disorders, including cancer, infectious diseases, cardiovascular conditions, and neurodegenerative diseases. Exosomes combine the benefits of synthetic nanocarriers and cell-mediated delivery while avoiding their limitations. They can avoid rapid clearance by the mononuclear phagocyte system (MPS) and reduce toxicity. Exosomes can be isolated using methods such as differential ultracentrifugation, immunoaffinity chromatography, size exclusion chromatography, polymer precipitation, and microfluidic technologies. Each method has its advantages and limitations. Exosomes can be characterized by size, protein, and lipid content. They have a unique ability to interact with recipient cells and deliver their contents. Exosomes can be used for therapeutic purposes, including vaccine adjuvants and immunotherapy. They have protective and regenerative effects, such as neuroprotection, cardioprotection, and hepatic regeneration. Exosomes can be loaded with drugs, nucleic acids, and proteins. They can be used for targeted drug delivery, including cancer treatment, neurodegenerative disorders, and infectious diseases. Exosomes have been tested in clinical trials for various applications, including melanoma and colorectal cancer. Exosomes derived from plants, such as grapes, have been evaluated for cancer treatment. Exosomes may serve as a next-generation drug delivery system with high drug carrying capacity, low immunogenicity, and non-cytotoxic effects. Future research will focus on improving exosome production, characterization, and clinical application. Exosomes have the potential to revolutionize drug delivery by providing a safe, efficient, and targeted approach for various diseases.Exosomes, naturally occurring nanocarriers, offer unique advantages for drug delivery due to their ability to interact with target cells and deliver therapeutic agents. They can be modified to express targeting moieties or carry specific biological activities. Exosome-based drug delivery systems are being developed for various disorders, including cancer, infectious diseases, cardiovascular conditions, and neurodegenerative diseases. Exosomes combine the benefits of synthetic nanocarriers and cell-mediated delivery while avoiding their limitations. They can avoid rapid clearance by the mononuclear phagocyte system (MPS) and reduce toxicity. Exosomes can be isolated using methods such as differential ultracentrifugation, immunoaffinity chromatography, size exclusion chromatography, polymer precipitation, and microfluidic technologies. Each method has its advantages and limitations. Exosomes can be characterized by size, protein, and lipid content. They have a unique ability to interact with recipient cells and deliver their contents. Exosomes can be used for therapeutic purposes, including vaccine adjuvants and immunotherapy. They have protective and regenerative effects, such as neuroprotection, cardioprotection, and hepatic regeneration. Exosomes can be loaded with drugs, nucleic acids, and proteins. They can be used for targeted drug delivery, including cancer treatment, neurodegenerative disorders, and infectious diseases. Exosomes have been tested in clinical trials for various applications, including melanoma and colorectal cancer. Exosomes derived from plants, such as grapes, have been evaluated for cancer treatment. Exosomes may serve as a next-generation drug delivery system with high drug carrying capacity, low immunogenicity, and non-cytotoxic effects. Future research will focus on improving exosome production, characterization, and clinical application. Exosomes have the potential to revolutionize drug delivery by providing a safe, efficient, and targeted approach for various diseases.