Mesenchymal stem cell（MSC）is one of the most significant sources of cell - based therapeutics for bone tissue regeneration. Investigations have demonstrated that MSC-derived exosomes can get beyond the restrictions of stem cell transplantation. Exosomes have been demonstrated to stimulate osteogenesis and osteogenic differentiation in the bone microenvironment both in vivo and in vitro. Exosomes play as a crucial role in intercellular communication by directly influencing the transcriptional level of their target cells. They carry DNA，mRNA，miRNA，protein，and lipids. The miRNAs are major regulators at various stages of cell differentiation，and modulate physiological and pathological processes through mRNA degradation or translation blockade. MSC - derived exosomes have advanced significantly in bone regeneration and repair recently. This article addresses the formation of MSC - derived exosomes，their application，and possible therapeutic procedures in the restoration of bone tissue defects.