Abstract: Malignant tumor is still one of the malignant diseases with high morbidity and mortality in the world. Its occurrence and development are influenced by various factors. Exosomes are nanoscale secretory vesicles that play an important role in the occurrence and development of malignant tumors, and have intercellular communication functions. The mechanism of action of traditional Chinese medicine in prevention and treatment of tumors is not yet comprehensive enough. This article discusses the relationship between exosomes and tumor development, relapse, metastasis and drug resistance, and the application of exosomes in the treatment of malignant tumors by traditional Chinese medicine, to provide reference for finding new breakthroughs in the treatment of malignant tumors.