Cerebral vascular disease has already become the first threat to Chinese people. Extracellular vesicles deliver multiple substances as microRNAs, and play roles in pathological processes of cerebrovascular diseases. In recent years, extracellular vesicles and microRNAs researches mainly focus on the protection of animal models, intervention of pathological processes and new biomarker researches. We summarize the research progress of extracellular vesicles in cerebrovascular disease from the above three aspects to provide new points and directions for early prevention and treatment of cerebrovascular disease.