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Extracellular vesicles are membraneous micro and nanovesicles produced by cells and used for bioactive cargo exchange. The vesicles derived from intracellular compartments are called exosomes. From a medicinal perspective, extracellular vesicles can be regarded as natural liposomes carrying a cell-specific bioactive cargo or as tiny bits of the cell providing building blocks for the recipient cells. According to the „liposome“ approach, Extracellular vesicles are potent drug-delivery vehicles; they can be engineered by inserting desired payload, modulating cargo release, and increasing specificity for particular cells or even intracellular organelles. On the other hand, in line with the second attitude, extracellular vesicles from healthy cells might serve as restoring blocks for diseased, inefficient cells. From this „building block“ perspective, extracellular vesicles are an alternative to cell therapy. Moreover, this alternative is more efficient and less risky than cell therapies. Extracellular vesicles have the potential to open a new era of medicines and enable the treatment of diseases that currently have no cure.