Gastric cancer, as one of the common malignant tumors worldwide, faces many challenges in its treatment, especially in late stage treatment and high recurrence rate. The angiogenesis of gastric cancer is a key process in the growth and metastasis of gastric cancer, therefore, researching and developing anti angiogenesis therapy methods is of great significance for the treatment of gastric cancer. Extracellular vesicles are nanoscale vesicles released by cells, serving as important messengers for intercellular communication. They regulate local and distant cell communication by transporting unique extracellular vesicle components, and can also promote or inhibit the development and progression of gastric cancer by regulating the growth, proliferation, and angiogenesis of tumor cells. Extracellular vesicles transport bioactive molecules from donor cells to recipient cells, leading to reprogramming of target cells and cascade reactions of molecules. In this review, we describe the relationship between extracellular vesicles and tumor angiogenesis in gastric cancer, as well as the current research status of extracellular vesicles in anti angiogenic therapy. Due to the importance of the physiological structure and function of extracellular vesicles in the angiogenesis of gastric cancer, the prospect of combining extracellular vesicles with anti angiogenic therapy for the treatment of gastric cancer is promising.