With continuous developments of regenerative medicine,mesenchymal stem cell-derived exosome(MSC-Exo)has attracted a growing attention of researchers with their inherent advantages of promoting tissue regeneration,an excellent biocompatibility and a great ease of penetration into tissues.Its specific mechanism has become a research hotspot.In cardiothoracic surgery,the role of MSC-Exo has been gradually examined.Currently the relevant studies have been conducted in the fields of cardiology,ung disease,lung transplant,tracheal transplantation and esophageal repair.The latest researches on MSC-Exo in the field of cardiothoracic surgery as well as its mechanism and outcomes were systematically summarized to provide references for more related researches in the future.