The heat shock protein (HSP) family consists of molecular chaperones that are evolutionary preserved from prokaryotes and mammals. The extracellular HSPs are now known to be involved in numerous processes including would healing, tissue regeneration, tumor progression and innate and adaptive immunity. In immunity, HSPs exhibit functional dichotomy in both innate and adaptive immunity, triggering or suppressing immune responses, but the majority of studies highlight their cytoprotective and immunoregulatory roles. Especially for several autoimmune diseases including rheumatic arthritis (RA) and systemic lupus erythematosus (SLE), for which specific causative self-antigens remain elusive, the therapeutic expansion of regulatory T cells specific to HSPs is considered a promising approach. In this review, we discuss several articles extracted from diverse biological and medical frontiers of extracellular HSP research.