Exosomes are endosomes derived extracellular vesicles of 30～100 nm size range, which carry nucleic acid and protein. Exosomes have powerful biological functions. Here we described the discovery and functions of exosomes. In addition, we also summarized the roles of exosomes in cancer growth, metastasis, immune escape, diagnosis, and treatment. Besides, functions of exosomes in a variety of cardiovascular physiological and pathological processes including atherosclerosis, myocardial infarction, ventricular remodeling, and cardiac regeneration are reported. In summary, a big knowledge is contained in these small vesicles.