Exosomes are small endosomally derived extracellular vesicles with a lipid bilayer structure, and they contain substances, such as proteins, lipids, DNA, RNA, micro(mi)RNA, and long non-coding(lnc)RNA. Exosomes participate in pathogen recognition, antigen presentation, autophagy regulation, immune activation and immunosuppression in bacterial infections. Studies have shown that miRNA, lncRNA, and proteins in exosomes play important roles in regulating antibacterial reactions in organisms. We reviewed the immunomodulatory effects of exosomes on several intracellular and extracellular bacterial infections to provide a reference for those studying the interactions between exosomes and bacterial infections.