Extracellular vesicles(EVs)are secreted by various cells and carry information such as parent cell-derived RNA,DNA,proteins,and lipids.They mediate information exchange between cells and organs,playing a crucial role in disease occurrence and development,diagnosis,treatment,and targeted drug delivery.EVs are also closely associated with traditional Chinese medicine theories and treatments.The qi-blood-fluid and visceral outward manifestation theories are the fundamental theories of traditional Chinese medicine.EVs belong to the fluid category and can reach other viscera through the blood vessels.They regulate the relationship between the viscera or cause imbalances between the viscera,resulting in disease.Chinese materia medica,which primarily includes traditional Chinese patent medicines and simple preparations,and Chinese herbal medicine,can help regulate the quantity and content of endogenous EVs in the body to improve pathological conditions.Additionally,EV-like particles derived from herbal medicines are a major form of pharmacologically active substances that contribute to the therapeutic effects of Chinese medicine in treating diseases.Furthermore,EVs can also be used as carriers to deliver drugs for targeted therapy.Therefore,exploring the relationship between traditional Chinese medicine and EVs will elucidate the modern scientific connotation of traditional Chinese medicine theories and reveal the mechanism of Chinese materia medica.The development of engineered EVs based on Chinese materia medica will provide novel strategies for clinical treatment.