Extracellular vesicle (EV)ābased therapies have emerged as a promising means in regenerative medicine. However, the conventional EV therapy strategy displays some limitations, such as inefficient EV production and lack of tissueāspecific repair effects. Here, it is reported that neonatalātissueāderived EV therapy (NEXT) is a potent strategy for precision tissue repair. In brief, large amounts of EVs with higher yield/purity can be readily isolated from desired tissues with less production time/cost compared to the conventional cellācultureābased method. Moreover, source factors, such as age and tissue type, can affect the repair efficacy of such tissueāderived EVs in different tissue injury models (skin wounds and acute kidney injury), and neonatalātissueāderived EVs show superior tissue repair potency compared with adultātissueāderived EVs. Different ageā or tissueātypeāderived EVs have distinct composition (e.g., protein) signatures that are likely due to the diverse metabolic patterns of the donor tissues, which may contribute to the specific repair action modes of NEXT in different types of tissue injury. Furthermore, neonatalātissueāderived EVs can be incorporated with bioactive materials for advanced tissue repair. This study highlights that the NEXT strategy may provide a new avenue for precision tissue repair in many types of tissue injury.