These tests, which assess different aspects of the patients' cognitive abilities, include abbreviated mental test (AMT), Alzheimer's disease assessment scale-cognitive subscale (ADAS-Cog), mini mental state examination (MMSE), the Montreal cognitive assessment (MoCa), and short blessed test (SBT). Such assessments, however, are subjective and detect diseases only at a late stage. [3-5] As pathological manifestations of neurodegenerative diseases are mainly confined within the brain and difficult to access, alternative methods for evaluating disease pathology involve either invasive biopsy or expensive brain imaging; these approaches are complex and challenging, resulting in limited clinical adoption. [6,7] Consequently, there is an intense interest in developing blood-based measurements [8-11] for safe, minimally invasive disease detection and longitudinal monitoring. Extracellular vesicles (EVs) are nanoscale membrane vesicles found abundantly in almost all bodily fluids. [12,13] These vesicles have recently emerged as a promising circulating biomarker for neurodegenerative diseases. Unlike most of the other molecules in the brain, which are impeded by the highly selective blood-brain barrier and cannot enter the circulation, recent studies have found that EVs can readily cross the blood-brain barrier. [14-17] Moreover, EVs contain diverse molecular contents reflective of their parent cells and extracellular environment. [18-20] These EV molecular cargoes are present in different organizational forms-either as inherited constituents from the parent Neurodegenerative diseases are heterogeneous disorders characterized by a progressive loss of function and/or death of nerve cells, leading to severe cognitive and functional decline. Due to the complex pathology, early detection and intervention are critical to the development of successful treatments; however, current diagnostic approaches are limited to subjective, late-stage clinical findings. Extracellular vesicles (EVs) have recently emerged as a promising circulating biomarker for neurodegenerative diseases. Actively released by diverse cells, EVs are nanoscale membrane vesicles. They abound in blood, readily cross the blood-brain barrier, and carry diverse molecular cargoes in different organizational states: these molecular cargoes are inherited from the parent cells or bound to the EV membrane through surface associations. Specifically, EVs have been found to be associated with several important pathogenic proteins of neurodegenerative diseases, and their involvement could alter disease progression. This article provides an overview of EVs as circulating biomarkers of neurodegenerative diseases and introduces new technological advances to characterize the biophysical properties of EV-associated biomarkers for accurate, blood-based detection of neurodegenerative diseases.