Abstract: How to repair tissue and organ damage caused by various diseases is a research hotspot in regenerative medicine. In recent years, stem cells have become the mainstay of therapeutic methods by virtue of their active biological components. Its mechanism of action is that its paracrine effect can regulate regenerative repair ability. An important component of this secretory regenerative environment is exosome, a vesicle material with a diameter of 40-150 nm, which mediates the transfer of proteins and nucleic acids across cell boundaries. This article reviews how the therapeutic transition from stem cell-based repairs towards exosome-based strategies happens, as well as the various functions and underlying mechanisms of exosomes.