Abstract: Extracellular vesicles (EVs) are nanoscale vesicles secreted by cells, characterized by a lipid bilayer membrane and enriched with nucleic acids, proteins, lipids, and other substances. They play an important role in intercellular communication, signal transduction, and other biological processes. EVs typically originate from animals, plants, and bacteria. Momordica charanti-derived extracellular vesicle-like particles (referred to as Momordica charanti EVs) are nanoscale vesicles extracted from the medicinal plant Momordica charanti, which have attracted widespread attention in recent years due to their potential applications in the treatment of various diseases. This review focuses on the therapeutic potential of Momordica charanti EVs in neuroprotection, cardioprotection, anti-tumor effects, and skin injury repair, as well as the challenges they face, providing new ideas for future research.