Abstract <p>A basic biological process that aids in aging, tissue homeostasis, and the development of cancer is cellular senescence. According to recent research, senescence-associated exosomes influence inflammation, fibrosis, the spread of senescence, and the advancement of cancer via mediating communication between tumor cells, immunological components, and stromal cells. There is growing evidence that, depending on the tumor setting, cargo composition, and microenvironmental conditions, senescence-associated exosomes can act as both tumor-suppressive and tumor-promoting mediators. Isolating senescence-specific exosomes and differentiating their functional cargo remains challenging despite advancements. With a focus on their dual roles in tumor suppression and tumor promotion, methodological advancements in their isolation, and their emerging translational applications in cancer diagnosis and therapy, the current review summarizes the biogenesis, molecular cargo, and functional consequences of senescence-associated exosomes.</p> Lay Summary <p>Aging and cancer are both impacted by cellular senescence. Accordingly, Senescence-associated Exosomes (SA-EXOs) can aid in the communication between tumors and the immune system. Although the SA-EXOs can promote tumor growth and resistance to treatment, they may also inhibit tumor development. Despite that, isolating and working with exosomes is still a difficult task. The current review aims to overview of recent advances in methodology and their possible use for diagnosis and treatment, as well as the complexity of the dual function of exosomes in relation to cancer progression.</p>