Abstract: Exosomes are lipid-dilayered extracellular vesicles in diameter of 30 to 120 nm. As the transporting carriers of signaling molecules, exosomes promote the exchange of signals among neurons, glial cells and vascular endothelial cells, which is tightly associated with the pathology statues of neurons and blood-brain barrier after onset of stroke. The pathology mechanisms mediated by exosomes include the regulation of neurogenesis, the enhancement of neuronal remodeling, the adaptation to stress and inhibition of immune response; besides, exosomes regulate the growth of astrocytes and the protection of vascular endothelial integrity. Accumulated evidences shown that exosomes as a novel biomarkers and drug carriers for clinical diagnosis or stroke therapy. In this paper, the role of exosomes in brain ischemia is reviewed.