AbstractMesenchymal stem cell‐derived exosomes (MSC‐Exos) are emerging as remarkable agents in the field of immunomodulation with vast potential for diagnosing and treating various diseases, including cancer and autoimmune disorders. These tiny vesicles are laden with a diverse cargo encompassing proteins, nucleic acids, lipids, and bioactive molecules, offering a wealth of biomarkers and therapeutic options. MSC‐Exos exhibit their immunomodulatory prowess by skillfully regulating pattern‐recognition receptors (PRRs). They conduct a symphony of immunological responses, modulating B‐cell activities, polarizing macrophages toward anti‐inflammatory phenotypes, and fine‐tuning T‐cell activity. These interactions have profound implications for precision medicine, cancer immunotherapy, autoimmune disease management, biomarker discovery, and regulatory approvals. MSC‐Exos promises to usher in a new era of tailored therapies, personalized diagnostics, and more effective treatments for various medical conditions. As research advances, their transformative potential in healthcare becomes increasingly evident.