Abstract: The incidence of lung cancer is increasing year by year, and it is currently the leading cause of cancerrelated deaths. Exosomes are endogenous membrane vesicles secreted by cells, and have been recognized as essential carriers of intercellular genetic materials, playing a bridging role in communication between different cells. In recent years, a growing body of research data have indicated that exosomes carrying genetic materials such as proteins, lipids, and nucleic acids (including lncRNA, microRNA, mRNA) play a significant role in the tumor microenvironment of lung cancer. This article mainly reviews the mechanisms of exosomes regulating the tumor microenvironment in lung cancer, and discusses the application value of exosomes as drug delivery vehicles and circulating biomarkers in the diagnosis and treatment evaluation of lung cancer.