Ischemic stroke remains a leading cause of mortality and disability worldwide, yet effective treat
ments—particularly for its sequelae—are still lacking. Emerging evidence highlights the significant potential of
extracellular vesicles (EVs) acting as natural nanocarriers for MicroRNA (miRNA) delivery in promoting neuro
logical recovery after ischemic stroke. This review comprehensively examines the relationships between EVs
from diverse cellular origins and ischemic stroke pathology. We explore their therapeutic roles in enhancing
post-stroke neurogenesis, modulating immune responses, stimulating angiogenesis, and suppressing apoptosis.
By synthesizing recent advances in this field, this paper proposes a promising and forward-looking therapeutic
strategy based on EV-mediated miRNA delivery for patients affected by ischemic stroke.
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