Plant-derived extracellular vesicles (PDEVs) are lipid bilayer nanoparticles, naturally produced by plant cells, with sizes ranging from 50 to 500 nm. Recent studies have highlighted their great potential in the biotechnological and medical fields, due to their natural origin, high biocompatibility and intrinsic therapeutic properties. PDEVs contain a complex biological cargo of proteins, lipids, nucleic acids and secondary metabolites, including antioxidants and anti-inflammatory molecules, making them ideal for biomedical applications such as drug delivery. These vesicles play a key role in intercellular communication and gene regulation, proving to be particularly promising in personalized medicine. Recent studies have highlighted their ability to improve drug stability and bioavailability, optimizing targeted release and minimizing side effects. Despite some challenges, such as compositional variability and the need for standardized protocols, PDEVs are at the gunsight of innovative research aimed at improving their loading capacity and therapeutic specificity. This review aims to provide a comprehensive overview of PDEVs, exploring their structure, isolation methods, functional characteristics, and applications, highlighting their advantages over synthetic nanoparticles and animal-derived extracellular vesicles, leading to an innovative and sustainable solution for the development of new therapeutic approaches.