Mesenchymal stemMesenchymal stem cells/stromal cells (MSCsMesenchymal stem cells) have emerged as promising therapeutic agents in regenerative medicine due to their multipotent capabilities, immunomodulatoryImmunomodulation properties, and ability to promote tissue repair. Recent studies suggest that the therapeutic effects of MSCsMesenchymal stem cells are primarily mediated by their paracrine release of extracellular vesiclesExtracellular vesicles (EVsExtracellular vesicles), including exosomesExosomes, which are small membrane-bound particles that facilitate intercellular communication. MSC-derived EVsExtracellular vesicles (MSC-EVsExtracellular vesicles) are enriched with proteins, RNAs, and lipids that can modulate the microenvironment of injured tissues, enhancing regenerative processes such as cell migration, proliferation, and differentiation. This chapter focuses on MSC-EVsExtracellular vesicles and their therapeutic potential. It covers various EV isolation methods and examines EV storage, characterization, and clinical applications, suggesting they offer a safer, scalable alternative to traditional cell-based therapies. Standardizing MSC-EVsExtracellular vesicles production, isolation, and characterization for clinical use remains challenging. Future research should focus on optimizing processes, understanding MSC-EVsExtracellular vesicles pharmacokinetics, and targeting mechanisms for maximum therapeutic potential.