Extracellular vesicles (EVs) are nanoscale membranous structures that play pivotal roles in intercellular communication across various biological contexts, encompassing both health and disease. These lipid bilayer-delimited nanovesicles facilitate the horizontal transfer of biomolecular cargo, including nucleic acids, proteins, lipids, and metabolites, from donor to recipient cells, thereby establishing critical cell-to-cell communication and influencing pathological processes (Figure 1). In the context of physiological health, exosomes are indispensable for maintaining homeostasis and regulating cellular functions. They mediate the exchange of information and biomolecules between cells, contributing to processes such as immune response modulation and tissue regeneration. In cancer, exosomes assume a complex role, often promoting disease progression by transporting oncogenic cargo and modulating the tumor microenvironment. In a distinct context, plant-derived exosomes, also known as plant extracellular vesicles, are emerging as intriguing entities with potential applications in agriculture, nutrition, and biomedicine. These plant exosomes harbor bioactive compounds and genetic material, serving as mediators of communication between plants and other organisms, thereby influencing crop health and defense mechanisms. Understanding the intricate functions and diverse roles of exosomes in these contexts holds promising prospects for advancing disease diagnostics and therapeutics and revolutionizing agricultural practices. EVs can be categorized into three principal subtypes based on their size and biological origins: exosomes (30–150nm), microvesicles (100–1,000 nm), and apoptotic bodies (1,000–5,000 nm). Notably, in the context of cancer, tumor-derived EVs (TDEVs) are