Oral squamous cell carcinoma is the most common phenotype in pathology, which accounts for 80% of all oral cancers. The therapeutic methods of oral squamous cell carcinoma include surgical excision, chemotherapy, and radiotherapy. Whereas, the high recurrence rate and poor prognosis lead to a 5‐year survival rate less than 50%. In order to explore more therapeutic strategies of oral squamous cell carcinoma, the relevant risk factors, mechanisms, and diagnostics are widely detected. The various exosome‐mediated biological effects on the development of oral squamous cell carcinoma have drawn lots of attention. Exosomes, a kind of extracellular vesicles secreted from host cells and transferred to other cells, show great potential in the regulations of tumorigenesis, progression, and metastasis on oral squamous cell carcinoma. Moreover, some studies reported that the exosomes could interact with tumor microenvironment and be applied to diagnosis or therapy of oral squamous cell carcinoma. In this work, we will summarize the frontier studies of exosomes in the tumor growth, tumor‐associated angiogenesis, invasion, and metastasis of oral squamous cell carcinoma, and then probe the current biological functions and applications of exosomes and exosome‐derived materials for the therapeutic strategies of oral squamous cell carcinoma, which would help us to update the understanding of exosomes in oral squamous cell carcinoma.