Ischemic　stroke,　a　leading　cause　of　global　mortality　and　disability,　faces　therapeutic　limitations　due　to　the　narrow　time　window　and　restricted　efficacy　of　current　interventions　such　as　thrombolysis　and　thrombectomy.　Recent　advancements　highlight　exosomes-nanoscale　extracellular　vesicles-as　promising　therapeutic　agents　owing　to　their　ability　to　cross　the　blood-brain　barrier　(BBB)　and　mediate　intercellular　communication.　This　review　summarizes　the　biological　characteristics　of　exosomes,　their　roles　in　neuroprotection,　neuroregeneration,　and　angiogenesis　following　ischemic　stroke,　and　emerging　strategies　utilizing　engineered　exosome-based　nanoparticles　for　targeted　therapy.　Despite　exosomes　showing　significant　advantages　in　the　treatment　of　ischemic　stroke,　their　clinical　transformation　still　faces　challenges,　including　the　standardized　production　of　exosomes,　the　clarification　of　biological　distribution　mechanisms,　and　the　assessment　of　immunogenicity　and　safety.　Overcoming　these　challenges,　exosomes　are　expected　to　become　a　safe　and　efficient　therapeutic　means　for　ischemic　stroke.