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Exosomes have emerged as novel nanovesicles that facilitate intracellular communication. The molecular content of exosomes is specific to their cell type of origin and reflective of the cells physiological status. Combined with their stability and accessibility in a variety of biofluids, exosomes may be used as biomarkers in a variety of diseases. Recent evidence suggests that exosomes have immunomodulatory functions that play a role in the severity and development of autoimmune disorders and cancers. This article focuses on the biomarker and therapeutic potential of exosomes for oral manifestation of autoimmune diseases and head and neck cancers., (Published 2018. This article is a U.S. Government work and is in the public domain in the USA.)