This review provides a comprehensive assessment of the therapeutic potential of stem cell-derived exosomes in neuroregenerative medicine, particularly for neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, and ischemic stroke. Exosomes, with their ability to enhance neuronal survival, modulate neuroinflammation, and promote synaptic plasticity, emerge as highly promising candidates for driving functional recovery in damaged neural tissues. By delivering a diverse array of bioactive molecules-ranging from neurotrophic factors to regulatory miRNAs-exosomes hold significant advantages over traditional therapeutic approaches, particularly in their ability to traverse the blood-brain barrier (BBB), a critical challenge in the treatment of central nervous system (CNS) disorders.