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Abstract Exosomes are membrane‐bound nanovesicles containing complex cargoes including proteins, lipids, and nucleic acids (mRNAs and microRNAs), which can be derived from most cells. Increasing evidence has implicated exosomes as key players in intercellular and even interorganismal communications. Exosomes confer stability and can direct their cargoes to specific cell types for promoting cell growth and tissue regeneration. Exosome cargoes also appear to act in a combinatorial manner to communicate directives to other cells. This Review focuses on recent developments and findings of exosomes applied towards applications in tissue engineering and regenerative medicine, including healing of the skin, cardiovascular, skeletal, nervous, and visceral systems. The underlying mechanisms of action of exosomes in tissue regeneration are also discussed. In addition, we highlight examples whereby exosomes have been integrated with hydrogels for biofabrication and other related biomedical utilities such as drug delivery.