Abstract:Exosomes (Exo) are a class of extracellular vesicles with diameters ranging from 30 to 150 nm, capable of carrying proteins, lipids, RNA, and other bioactive molecules derived from donor cells. These nanoscale vesicles are released into the extracellular environment through complex secretory mechanisms and participate in various biological processes, playing a particularly important role in intercellular communication. Atherosclerosis (As) is a chronic inflammatory vascular disease characterized by lipid deposition, inflammatory responses in the vessel wall, and luminal stenosis. Exosomes serve as crucial information carriers in the initiation and progression of As, influencing the disease course by modulating signaling pathways and gene expression. This article reviews the biogenesis of exosomes, discusses their functional roles in the progression of As, and explores their potential applications in clinical diagnosis and treatment.