| Bone metabolic diseases is one of the most common diseases in the elderly, which seriously affects the quality of life of the elderly. However, the pathogenesis of bone metabolic diseases is not yet fully understood. It is known that the balance between osteoblasts and osteoclasts requires the exchange of information molecules，and the communication mechanism is complicated. Exosomes are membranous vesicles that are fused to the cell membrane inside the cell then released to the outside of the cell, and can communication between cells. This article summarizes and analyzes the roles of exosomes in bone metabolism, and demonstrates that exosomes are closely related to bone metabolic diseases from the aspects of bone metabolism, stem cell repair, miRNA regulation，and skeletal muscle differentiation, with the purpose of providing new directions and references for the basic research and clinical prevention and treatment of bone metabolic diseases. |