BACKGROUND: Platelet-derived extracellular vesicles are the most abundant vesicles in the circulation, rich in bioactive molecules, genetic material, proteins and other information molecules, involved in cellular communication and material exchange, not only has good procoagulant activity, but also has the promotion of tissue repair and regeneration, and has a wide range of applications in regenerative medicine. OBJECTIVE: To elaborate the secretion mechanism of platelet-derived extracellular vesicles, their application in regenerative medicine, and limiting factors for clinical transformation, and to provide some theoretical support for the clinical translation of platelet-derived extracellular vesicles. METHODS: A computerized search of the PubMed database from January 2005 to August 2023 was applied to articles relating to platelet-derived extracellular vesicles with the search terms “platelet-derived, platelet-rich plasma, extracellular vesicles, isolated, microvesicles exosomes, applications”. A total of 62 articles that met the subject criteria were finally included. RESULTS AND CONCLUSION: (1) Activated platelet-derived extracellular vesicles produce two types of vesicles, platelet-derived microparticles, whose secretion may be associated with the asymmetry of the actin cytoskeleton, and platelet-derived exosomes, which may be associated with the regulation of H+ -ATPase. (2) Platelet-derived extracellular vesicles are potential effectors of platelet concentrates and platelets themselves, and may intervene in tissue regeneration by promoting angiogenesis, influencing cellular behavior, promoting coagulation and hemostasis, and exerting inflammatory effects. (3) Platelet-derived extracellular vesicles have been reported preclinically in the field of regenerative medicine such as tissue injury, muscle regeneration, cartilage regeneration, and osteoarthritis, and clinical trial data are available as potential therapeutic approaches for wound healing. However, factors such as isolation methods, sample sources, and the types of activators limit the clinical translation of platelet-derived extracellular vesicles into the field of regenerative medicine. (4) In the future, platelet-derived extracellular vesicles may become a cell-free alternative to platelet-rich plasma in regenerative medicine, but the clinical translation of platelet-derived extracellular vesicles needs to actively search for specific markers to differentiate platelet-derived microparticles from plateletderived exosomes. The mechanism of activator-stimulated platelet-derived extracellular vesicle production, as well as the optimal method of platelet-derived extracellular vesicle collection, the optimal method of storage, the shelf life of the platelet-derived extracellular vesicles, the recommended dosage of plateletderived extracellular vesicles for clinical application, and the optimal clinical indications need to be further investigated. [ABSTRACT FROM AUTHOR]