With the development of aging in the world, Alzheimer"s disease (AD) has become a disease that seriously jeopardizes human health. Given the complexity of the pathogenesis of AD, there is a lack of therapeutic options that can effectively intervene in the disease process. Mesenchymal stem cell-derived exosomes (MSC-Exosomes) have emerged from a new perspective in medicine due to their powerful regenerative properties and repair function. They are donor-derived, low immunogenicity, easy to store, natural carriers, and low risk of tumor formation, and have shown great potential in the treatment of AD and post-treatment rehabilitation. showing great potential. Based on this, this article introduces the pathological mechanisms of Alzheimer"s disease and the characteristics of MSC-Exos, and provides a detailed review of the role of MSC-Exos in the treatment of AD, including anti-inflammatory, immunomodulatory, and related signaling pathway modulation, and discusses the latest progress in related research, with the aim of providing a new direction for therapeutic approaches to Alzheimer"s disease.