Exosomes are naturally occurring, nanosized (30–150 nm) vesicular vesicles that are released from cells by physiological or pathological events. Exosomes are becoming more and more popular because to their many advantages over traditional nano carriers, such as their capacity to avoid metabolic degradation or homing in the liver and their absence of unwanted accumulation before reaching their targeted destinations. Multiple studies have demonstrated the potential of exosomes in delivering therapeutic agents such as RNA molecules, proteins, small molecules, CNS acting drugs and chemotherapeutic drugs. By using exosomes as a drug delivery system, it is possible to enhance the BBB penetration and improve the pharmacokinetic and pharmacodynamic profiles of drugs, increase bioavailability, reduce toxicity and target specific cells or tissues. The use of exosomes also allows for the development of personalized medicine by using patient-derived exosomes for targeted therapy. Their biocompatibility and low immunogenicity make exosomes an attractive option for clinical use; however, there is still much research needed to optimize their therapeutic potential. Recent developments in the utilisation of exosomes as drug delivery systems were covered in this article. We looked at a thorough analysis of exosomes as therapeutic drug carriers and delivery systems across biological membranes, which included their structure, biogenesis, and importance as drug delivery vehicles. We alsohighlighted modified and derived exosomes that have been developed for targeted drug delivery and cargo loading. We also concentrated on isolating, characterising, purifying, and producing large quantities of exosomes, and we noted the different formulations