<p>Inflammation-related disorders constitute a major global health challenge, with annual incidence exceeding tens of millions of cases and economic losses surpassing hundreds of billions USD. These burdens significantly impact both healthcare systems and socioeconomic development. Current clinical therapies are limited by suboptimal efficacy, which poses health risks to patients and underscores the demand for innovative therapeutic strategies. Emerging evidence demonstrates that extracellular vesicles (EVs) exhibit significant therapeutic advantages over conventional pharmacological interventions in managing inflammatory disorders. Native EVs possess inherent advantages including superior biocompatibility, structural integrity, and unique biological barrier penetration capacities, positioning them as promising therapeutic agents for inflammatory conditions. Engineered EVs can be functionalized with targeted delivery systems to transport bioactive components, such as miRNAs and proteins, enabling precise modulation of inflammatory signaling pathways. This approach enhances therapeutic efficacy, shortens treatment duration, reduces morbidity rates, and decreases healthcare costs. This review examines the therapeutic potential of EVs in inflammatory diseases and summarizes recent advances in their application to specific inflammatory disorders. We discuss the clinical translation challenges of EVs and highlight their prospects for inflammatory disease therapeutics.</p>