ObjectiveTo review the mechanisms of bioactive substances of mesenchymal stem cells-derived exosomes (MEX) in tissue repair and analyze the therapeutic values of MEX. MethodRecent relevant literature about MEX for tissue repair was extensively reviewed and analyzed. ResultsThe diameter of exosomes ranges from 30 to 100 nm which contain an abundance of bioactive substances, such as mRNA, microRNA, and protein. The majority of the exact bioactive substances in MEX, which are therapeutically beneficial to a wide range of diseases, are still unclear. ConclusionsBioactive substances contained in the MEX have repairing effect in tissue injury, which could provide a new insight for the clinical treatment of tissue damage. However, further studies are required to investigate the individual differences of MEX and the possible risk of accelerating cancer progression of MEX.