<p>Modern medicine has achieved groundbreaking advancements in disease diagnosis and treatment, yet significant challenges remain in managing conditions such as age-related diseases, tumors, autoimmune disorders, and neurological conditions. Conventional drug therapies often suffer from inadequate targeting, severe toxic side effects, and limited therapeutic efficacy, leading to adverse clinical outcomes such as disease recurrence and organ dysfunction. In recent years, mesenchymal stem cells (MSCs) have demonstrated transformative potential in regenerative medicine and disease therapy. Leveraging their multipotent differentiation potential, immunomodulatory properties, and paracrine functions, MSCs offer innovative strategies by enhancing tissue repair and microenvironmental homeostasis. Notably, ferroptosis—a newly identified form of regulated cell death—has emerged as a critical research frontier. MSCs and their exosomes exhibit a remarkable ability to modulate ferroptosis by regulating iron ions and lipid peroxide levels. This review provides an in-depth analysis of the molecular pathways through which MSCs influence ferroptosis. Additionally, it explores recent advances in ferroptosis regulation in transplanted MSCs, shedding light on their clinical applicability. In summary, this work underscores the therapeutic promise of MSCs in treating ferroptosis-associated diseases.</p>