 Mitochondria-derived vesicles, MDVs, play important roles in maintaining mitochondrial health under both mild and severe stress conditions. They are generated under mild stress to transport defective mitochondrial components, such as mitochondrial DNA, proteins, and lipids, out of the cell. When this fails, MDVs are also generated to facilitate mitophagy and mitochondrial dynamics to restore mitochondrial structure and function. Under severe oxidative stress, MDVs are generated to rescue mitochondria from damage. Furthermore, MDVs may be used as a therapeutic tool to treat diseases caused by mitochondrial dysfunction, such as kidney stone disease. This article was authored by Saktithep Chairit and Visif Thongbunkid.