Abstract: Exosomes are extracellular vesicles with diameters ranging from 30 to 150 nm, carrying abundant bioactive substances such as nucleic acids, proteins, and lipids. They play a crucial role in intercellular communication and material exchange. In vitro and in vivo studies indicate that stem cell-derived exosomes can delay intervertebral disc degeneration through a triple mechanism: regulating molecules centered on microRNA, inhibiting apoptosis, reducing inflammatory factor expression, and maintaining extracellular matrix homeostasis. This paper provides a systematic review of recent research progress on stem cellderived exosomes in the treatment of intervertebral disc degeneration. It delves into their underlying mechanisms of action and discusses current research challenges and future development directions.