Intercellular communication between lymphocytes plays a fundamental role in numerous immune responses. Previously, we demonstrated that hyperhomocysteinemia (HHcy) induced T cell intracellular glycolytic‐lipogenic reprogramming and IFN‐γ secretion via pyruvate kinase muscle isozyme 2 (PKM2) to accelerate atherosclerosis. Usually, B cells partially obtain help from T cells in antibody responses. However, whether PKM2 activation in T cells regulates B cell antibody production is unknown. Extracellular vesicles (EVs) are important cellular communication vehicles. Here, we found that PKM2 activator TEPP46‐stimulated T‐cell–derived EVs promoted B‐cell IgG secretion. Conversely, EVs secreted from PKM2‐null T cells were internalized into B cells and markedly inhibited B‐cell mitochondrial programming, activation, and IgG production. Mechanistically, lipidomics analyses showed that increased ceramides in PKM2‐activated T‐cell EVs were mainly responsible for enhanced B cell IgG secretion induced by these EVs. Finally, quantum dots (QDs) were packaged with PKM2‐null T cell EVs and anti‐CD19 antibody to exert B‐cell targeting and inhibit IgG production, eventually ameliorating HHcy‐accelerated atherosclerosis in vivo. Thus, PKM2‐mediated EV ceramides in T cells may be an important cargo for T‐cell–regulated B cell IgG production, and QD‐CD19‐PKM2‐null T cell EVs hold high potential to treat B cell overactivation‐related diseases.—Yang, J., Dang, G., Lü, S., Liu, H., Ma, X., Han, L., Deng, J., Miao, Y., Li, X., Shao, F., Jiang, C., Xu, Q., Wang, X., Feng, J. T‐cell‐derived extracellular vesicles regulate B‐cell IgG production via pyruvate kinase muscle isozyme 2. FASEB J. 33, 12780–12799 (2019). http://www.fasebj.org