 The use of mesenchymal stem, stromal cells, MSCs, has become increasingly popular due to their ability to modulate the immune system and promote tissue repair. However, the side effects associated with Master of Science transplantation can be detrimental to patients. Recent research suggests that exosomes derived from MSCs may provide a more effective way to deliver MSC's beneficial effects without the risk of side effects. This review summarizes the current clinical trials using MSC exosomes for immunomodulation, regenerative medicine, gene delivery, and beyond. The authors also discuss the potential benefits of MSC exosomes compared to MSCs, as well as the challenges and future directions of exosome utilisation in clinical studies.