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Exosomes are extracellular vesicles that are released from the cell into the extracellular microenvironment, and are a carrier of biological information transmitted over long distances, which have a dual regulatory effect on the immune system. Studies have shown that viruses can hold the endosomal-exosomal pathway hostage to spread. This review describes the role played by exosomes in viral infections. On the one hand, exosomes can transmit antiviral substances and trigger immune responses against viral infections, and on the other hand, exosomes can serve as potential mediators of viral transmission, which have been shown to be closely related to the transmission and immune escape of a variety of viruses. Understanding the role of exosomes in viral infections is essential for the detection of viruses in the blood, for improving blood safety, and for the search and development of antiviral drugs.