Parkinson disease（ PD） is a neurodegenerative disease， characterized by irreversibility， high incidence and high morbidity. In this context， early identification and intervention are of great significance for ameliorating PD. However， at present， there is a lack of objective laboratory indexes in clinical practice， while the evidence for early disease modification by pharmacotherapy is insufficient. Exosomes are vesicles produced by cells and released to the extracellular， containing abundant bioactive molecules. Central nervous system derived exosomes are an important source for screening markers of disease diagnosis， differential diagnosis， staging and prognosis. Changes in their containing PD signature proteins， such as alpha-synuclein， DJ-1 and RNA molecules reflect the pathophysiological state of the organism. Exosomes from mesenchymal stem cells show the function of tissue repair and neuroprotection， paralleling to that of their parental cells. Meanwhile， therapeutic agents（ such as catalase， dopamine， small interfering RNAs， etc）. can be targeted to the brain by exosomes and act on different pathologic pathways of PD. This paper reviews the recent advances on exosomes in the occurrence， development， diagnosis and treatment of PD， and discusses the current problems and possible future research directions.