Pancreatic cancer is a digestive system malignancy with high mortality. Exosomes are membranous vesicles with a diameter of 30-200 nm, which are released by various cells into the extracellular matrix. Exosomes can carry various molecules such as RNA, DNA, proteins, and lipids and bind to target cells to mediate the communication between cells and regulate the physiological function of cells. Recent studies have shown that exosomes play an important role in the development and progression of pancreatic cancer and can help with the early diagnosis of pancreatic cancer, and exosomes are expected to become a new biomarker for the diagnosis of pancreatic cancer. This article reviews the research advances in the role of exosomes in the early diagnosis of pancreatic cancer.