Abstract: Exosomes are bilayer-lipid membrane nanovesicles with 30-150nm in diameter. They are secreted by various types of cells, with abundant proteins, mRNA and microRNA, and involved in intercellular substance exchange and signal transduction. Exosomes can promote the occurrence and development of leukemia to further affect the drug resistance by affecting cell proliferation, apoptosis and autophagy, regulating bone marrow microenvironment, promoting angiogenesis and inhibiting bone marrow hematopoiesis. They can also be used as the target of drug therapy for leukemia. This article reviews the composition and formation of exosomes and the roles of tumor-derived exosomes in leukemia in recent years.