With the development of stem cell research,adipose derived mesenchymal stem cell(ADSC)and adipose derived mesenchymal stem cell exosome(ADSC-Exo)have become a hot research topic in the field of gynecology.ADSC,a type of adipose-derived mesenchymal stem cells,has high proliferative capacity and multidirectional differentiation potential like other mesenchymal stem cells.ADSC-Exo can deliver a variety of biologically active molecules,such as microRNAs,proteins,and cytokines through released extracellular vesicles to play a certain regulatory role in the target cells.The application of ADSC-Exo in gynecology has also received increasing attention.Some studies have shown that ADSC-Exo can promote endometrial regeneration and repair,bringing hope to patients with intrauterine adhesion and infertility.In addition,some studies mentioned that ADSC-Exo also has potential in the treatment of chronic endometritis,ovarian insufficiency,polycystic ovary syndrome and gynecological malignancies.This paper reviews the application and advancements of ADSC-Exo in gynecology.